J Korean Radiol Soc.  1989 Feb;25(1):152-161. 10.3348/jkrs.1989.25.1.152.

Ultrasonographic evaluation of infants with non-bilious vomiting

• Lee EJ
• Oh KK
• Choi SH
• Lee C

• KMID: 2383165
• DOI: http://doi.org/10.3348/jkrs.1989.25.1.152

Abstract

Twenty two young infants presenting with non-bilious vomiting were examined by ultrasonography in order toevaluate the diagnostic value of ultrasonograpy in hypertrophic pyloric stenosis. We analysed the ultrasonographicfindings in 16 cases of the hypertrophic pyloric stenosis, which were compared with operative findings. Ourresults were as follows: 1. Hypertropphic pyloric stenosis were mostly diagnosed between 3 and 8 weeks of age, andhad high incidence in first male baby, also pyloric mass were palpated in 80% of cases. Eight cases who werediagnosed within 4 weeks of age had early onset of symptom with short duration, many had no palpable mass. 2. Allcases with hypertrophic pyloric stenosis demonstrated the pyloric muscle thickness to be 4mm or greater, thepyloric diameter to be 1.0cm or greater, and the pyloric channel length to be 1.6cm or greater, therefore whenultrasonographic measurements were compatible with the above, the definite diagnosis of hypertrophic pyloricstenosis could be made. 3. Operative measurement of the pyloric muscle thickness was between 4 and 7 mm(mean,5.0mm), the pyloric diameter was 1.0 and 2.0 cm(mean, 1.67cm),the pyloric channel length was between 2.0 and3.0cm(mean, 2.24cm), showing good correlation with ultrasonographic measurements. 4. Other findings onultrasonography which could help diagnosis of hypertrophic pyloric stenosis included delayed gastric empting,hyperperistalsis, teat and beak sign, failure of passage or little passage of fluid, target and doughnut sign,cervix sign, and double tract sign. 5. Ultrasonography was useful in postperative course and prognosis ofhypertrophic pyloric stenosis and also differentiating other cause of non-bilious vomiting. In conclusion,ultrasonography was a quick, safe, and accurate method of evaluating young infants with non-bilious vomiting, andit should be the initial diagnostic procedure in infants suspected of hypertrophic pyloric stenosis because ofearly detectability, high accuracy of pyloric measurements, and usefullness in postpyloromyotomy follow-up.

MeSH Terms

Animals
Beak
Diagnosis
Follow-Up Studies
Humans
Incidence
Infant*
Male
Methods
Prognosis
Pyloric Stenosis
Pyloric Stenosis, Hypertrophic
Ultrasonography
Vomiting*