创伤与治疗杂志

On the 2:1 Preponderance of Male Infants in the incidence of Pyloric Stenosis and in Convictions for “Shaken Baby Syndrome”.

Abstract

Talbert DG*

Introduction: It is known that in Pyloric Stenosis, Macrocephaly, and convictions for “Shaken Baby Syndrome”(SBS) the infant is twice as likely to be male as female. It has previously been hypothesised that the injuries assumed to prove SBS actually result from transient venous hypertension occurring during violent vomiting caused by pyloric stenosis. Macrocephaly also can be explained in terms of venous hypertension. By 1912 the pylorus had been recognized as a three part organ (antrum, canal, sphincter) independent of the stomach, but capable of cooperative action. Much of this has now been forgotten and the pylorus is considered to be merely the distal part of the stomach. Understanding of the early development and function of the pylorus is essential to understanding the development of stenosis and hence assymetrical gender distribution. Mechanics: At birth the human pylorus is proportionately longer and thinner than in the adult. In the first few months of life, before weaning, it has to grow thicker and more compact to be powerful enough to reduce food lumps to paste before passing food onwards into the duodenum. Testosterone stimulates contractile protein production, but not cell length, in the smooth muscle cells surrounding the pylorus. In males muscle will may grow too bulky for the current circumference and expand inwards, producing stenosis. Conclusion: The 2:1 male gender bias in pyloric stenosis, and hence conviction rate for SBS, arises naturally from this Transient