Abstract. In a large metropolitan general hospital, a high incidence of congenital hypertrophic pyloric stenosis was noted in non-Caucasian groups. Bile-free. Hypertrophic pyloric stenosis (HPS) refers to the idiopathic thickening of gastric pyloric musculature which then results in progressive gastric outlet obstruction. This is a condition that can affect babies in the first few weeks of life, usually at about 6 weeks. It tends to affect boys more than girls. Pyloric stenosis is a.

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The pylorus, however, appears sonographically normal. Support Center Support Center. Assess the appearance and measurements of the pylorus Fig.

Congenital Hypertrophic Pyloric Stenosis

National Center for Biotechnology InformationU. Identification of the pylorus First step: Reed AA, Michael K. HPS is the most common surgical cause of vomiting in infants. The other principal sonographic size criterion is the length of the pyloric canal.

Congenital Hypertrophic Pyloric Stenosis

Thickening of the pyloric canal may be transient due to peristalsis or pylorospasm. Unequivocal palpation of a right upper quadrant mass was successful in less than half of the patients in this series, and radiographic studies were helpful in establishing the proper diagnosis in the remainder.


Having a systematic approach will improve the sensitivity of the technique. Diagnostic measurements include mnemonic ” number pi “:.

Prompt US diagnosis is important as these late findings make the infants sub-optimal candidates for surgery. Gastrointestinal tract imaging in pyloruz J Diagn Med Sonography. The operation is curative and has very low morbidity 4,5.

Clinical features HPS is the most common surgical cause of vomiting in infants.

Case 5 Case 5. The US examination allows the radiologist to perform a brief clinical history, which can reveal essential clues to the diagnosis.

Antro-pyloric canal values from early prematurity to full-term gestational age: Case 3 Case 3. Open in a separate window.

Pyloric stenosis | Radiology Reference Article |

Bile-free emesis was consistently reported, and admission was frequently delayed. Tips and tricks One common difficulty is a stomach filled with gas Fig. In premature infants, HPS develops stenossi the same age as in term infants, but their smaller size should be taken into consideration. US also allows a dynamic study with direct observation of the pyloric canal morphology and behaviour.

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US is the modality of choice for the diagnosis of hypertrophic pyloric stenosis HPS. Case 8 Case 8. Liver fracture can occur with improper abdominal palpation techniques. Three patients not operated upon who were followed for more than two years still have evidence of gastric dysfunction. The US should be performed by an experienced radiologist.

Hypertrophic pyloric stenosis in the infant without hipertrofii palpable olive: The imaging features of the normal pylorus and the diagnostic findings in HPS are reviewed and illustrated in this pictorial essay. It is important to be familiar with the normal and hypertrophied pyloric appearances, as this will provide a greater diagnostic confidence, assisting in early diagnosis and improving the management of infants with HPS.

A history of an affected first-degree relative increases the risk more than five-fold [ 5 ]. Ohshiro K, Puri P.