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Hypertrophic Pyloric Stenosis

Reed CMR - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Wilford Hall USAF Medical Center

ABSTRACT

Diagnosis: Hypertrophic Pyloric Stenosis

History: 4 week old male has been experiencing projectile vomiting for 5 days. Parents complain of increased fussiness, decreased urine frequency, and progressive infant fatigue. Emesis is non-bilious and is almost always the same consistency of the infant’s most recently ingested feeds.

Findings: Selected longitudinal ultrasound images of the gastric antrum and pylorus demonstrate pyloric hypertrophy and stenosis. The single wall thickness is 4mm (< 3mm normal). The pyloric length is 16 mm (< 15mm normal). An early “cervix sign” is suggested on image #1, as the hypertrophied pylorus pushes into the antrum. “Shouldering” of the antrum is noted at the distal stomach on all of the images. Prolonged real time examination demonstrated frequent exaggerated peristaltic waves and no passage of fluid through the stenosed gastric outlet.

Ddx: Hypertrophic Pyloric Stenosis Infantile Pylorospasm (Wall Thickness 1.5-3mm with partial outlet obstruction and only delayed gastric emptying)

Exam: Physical exam is significant for weight less than the 10th percentile for age and no palpable masses.

No MeSH data available.


Longitudinal Ultrasound Image of the Pyloris
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Related In: Results  -  Collection

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MPX2392_synpic17129: Longitudinal Ultrasound Image of the Pyloris


Hypertrophic Pyloric Stenosis

Reed CMR - MedPix

Longitudinal Ultrasound Image of the Pyloris
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2392&req=5

MPX2392_synpic17129: Longitudinal Ultrasound Image of the Pyloris

View Article: MedPix Image - MedPix Case

Affiliation: Wilford Hall USAF Medical Center

ABSTRACT

Diagnosis: Hypertrophic Pyloric Stenosis

History: 4 week old male has been experiencing projectile vomiting for 5 days. Parents complain of increased fussiness, decreased urine frequency, and progressive infant fatigue. Emesis is non-bilious and is almost always the same consistency of the infant’s most recently ingested feeds.

Findings: Selected longitudinal ultrasound images of the gastric antrum and pylorus demonstrate pyloric hypertrophy and stenosis. The single wall thickness is 4mm (< 3mm normal). The pyloric length is 16 mm (< 15mm normal). An early “cervix sign” is suggested on image #1, as the hypertrophied pylorus pushes into the antrum. “Shouldering” of the antrum is noted at the distal stomach on all of the images. Prolonged real time examination demonstrated frequent exaggerated peristaltic waves and no passage of fluid through the stenosed gastric outlet.

Ddx: Hypertrophic Pyloric Stenosis Infantile Pylorospasm (Wall Thickness 1.5-3mm with partial outlet obstruction and only delayed gastric emptying)

Exam: Physical exam is significant for weight less than the 10th percentile for age and no palpable masses.

No MeSH data available.