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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It has an incidence of 3 per 1, live births per year, although wide variations have been documented with geographic location, season and ethnic origin [ 3 ].
The condition is characterised by thickening of the muscular layer and failure of the pyloric canal to relax resulting in gastric outlet obstruction. Ultrasound is the modality of choice in the right clinical setting because of its advantages over a barium meal are that it directly visualizes the pyloric muscle and does not use ionising radiation.
You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Case 14 Case Conclusion Pyloric US examination is a dynamic investigation, which should be performed in a systematic way.
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 hipertroif. This disease usually presents between the second and sixth weeks of life, more commonly in the white population, in males male: The main diagnostic criterion is measurement of the thickness of the muscular layer.
Pylorue pyloric stenosis in the infant without a palpable olive: New insights into the pathogenesis of infantile pyloric stenosis. Postoperative emesis following adequate operation is not unusual, occurring approximately one-third of the time. Published online May 1. The US examination allows the radiologist to perform a brief clinical history, hupertrofi can reveal essential clues to the diagnosis. Tips and tricks One common difficulty is a stomach filled with gas Fig.
Introduction Hypertrophic pyloric stenosis HPS is the most frequent surgical condition in infants in the first few months of life [ 1 ]. Borderline measures Thickening of the pyloric canal may be transient due to peristalsis or pylorospasm.
With prolonged observation, pyloric opening may be visualised. Infantile stfnosis pyloric stenosis. National Center for Biotechnology InformationU. Figure 3 Figure 3. Hpiertrofi identification of the pylorus can be difficult, but a systematic approach will improve chances of success. Initial medical management is essential with rehydration and correction of electrolyte imbalances.
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Case 9 Case 9. Liver fracture can occur with improper abdominal palpation techniques. Hypertrophic pyloric stenosis HPS is the most frequent surgical condition in infants in the first few months of life [ 1 ].
Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis
The US should be performed by an experienced radiologist. The pylorus, however, appears sonographically normal. If possible the examination should be performed after a feeding and accompanied by a parent.
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. Journal List Insights Imaging v. Diagnostic measurements include mnemonic ” number pi “:. Thickening of the pyloric canal may be transient due to peristalsis or pylorospasm.
This can be performed both open and laparoscopically. Ultrasonographic features of normalization of the pylorus after pyloromyotomy for hypertrophic pyloric stenosis. The treatment of HPS is surgical pyloromyotomy. The operation is curative and has very low morbidity 4,5. A history of hipsrtrofi affected first-degree relative increases the risk more than five-fold [ 5 ]. Abstract In a large metropolitan general hospital, a high incidence of congenital hypertrophic pyloric stenosis was noted in non-Caucasian groups.
Check for errors and try again. A stomach completely filled with milk can also cause artefacts, other possibilities are to give the infant water or even to place a nasogastric tube, empty the stomach and hiperfrofi fill it with water.
Pyloric stenosis is the result of both hyperplasia and hypertrophy of the pyloric circular muscles fibres. Prompt US diagnosis is important as these late findings make the infants sub-optimal candidates for surgery. Pyloric US examination is a dynamic investigation, which should be performed in a systematic way.
Hypertrophic pyloric stenosis | Radiology Case |
The pathogenesis of this is not understood. Particular attention should be paid to pre-term infants and those in the younger age range. A succussion splash may be audible, and although common, is only relevant if heard hours after the last meal 6.
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