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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There are four main theories Three patients not operated upon who were followed for more than two years still have evidence of gastric dysfunction.
Case 6 Case 6. Postoperative emesis following adequate operation is not unusual, occurring approximately one-third of the time.
Antropiloric muscle thickness at US in infants: Open in a separate window. National Center for Biotechnology InformationU.
Author information Article notes Copyright and License information Disclaimer. Common difficulties in performing the examination and tips to help overcome them will also be discussed.
Congenital Hypertrophic Pyloric Stenosis
The identification of the pylorus can be difficult, but a systematic approach will improve chances of success. It is important to carry out a systematic and dynamic study and to be aware of the common technical difficulties and how to overcome them.
Gastrointestinal tract imaging in children: 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.
Due to the loss of hydrochloric acid in the gastric contents from persistent vomiting, patients are at risk of electrolyte imbalance, specifically the characteristic hypochloraemic metabolic alkalosis. Thank you for updating your details. In HPS the thickened muscle and elongated pylorus are fixed over time, which helps the operator to identify this condition. Ultrasound US is the preferred diagnostic modality [ 2 ] as it is a non-invasive technique, allowing direct observation of the pyloric canal morphology and behaviour.
Articles Cases Courses Quiz. The radiologist should be aware of the pitfalls of the examination and how to overcome them.
Associated Data Supplementary Materials. US is the first modality of choice when there is clinical suspicion of HPS, as it is non-invasive and does not use radiation, which is a crucial advantage in children. Before performing the US, some general conditions for examining infants should be addressed, as these can affect the quality of the examination.
On upper gastrointestinal fluoroscopy:. Pyloric stenosis is the result of both hyperplasia and hypertrophy of the pyloric circular muscles fibres.
Hypertrophic pyloric stenosis | Radiology Case |
Case 1 Case 1. Of course, clinically it is important to consider other causes of vomiting in infancy. National Center for Biotechnology InformationU. Initial medical management is essential with rehydration and correction of electrolyte imbalances. It is important to be aware that tangential views and contractions can produce pseudo-thickening. Identification of the pylorus First step: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys.
We describe a systematic approach to the ultrasound US examination of the antropyloric region in children. Bile-free emesis was consistently reported, and admission was frequently delayed. Typically the infant has a voracious appetite.
Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis
The operation is curative and has very low morbidity 4,5. Open in a separate window. It is important to hipertrfi 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.