Hypertrophic pyloric stenosis in the infant without a palpable olive: accuracy of sonographic diagnosis.

Hernanz‐Schulman, Marta; Sells, L L; Ambrosino, M. M.; Heller, Richard M.; Stein, Sharon M.; Neblett, Wallace W.

doi:10.1148/radiology.193.3.7972822

Cited by 131 publications

(77 citation statements)

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“…Ultrasonography is the most sensitive test to diagnose pyloric stenosis in the absence of a palpable olive mass [24]. Ultrasonographic imaging had a sensitivity of 98%, specificity of 100% with a positive predictive value of 100% and 90% respectively [21], which is approximately similar to present study results.…”

Section: Discussionsupporting

confidence: 90%

Ultrasound Value in the Early Diagnosis and Exclusion of Idiopathic Hypertrophic Pyloric Stenosis: 10 Years Experience at Babylon Governorate

Resheed¹

2017

J Gen Pract

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Background: Idiopathic Hypertrophic Pyloric Stenosis (IHPS) is one of the most common surgical conditions of early infancy, presenting in 1.5 to 4 per 1000 live births. Despite this high prevalence, the precise etiology remains poorly understood. The diagnosis is made primarily with history and physical examination. Projectile, non-bilious vomiting is the classic presentation of an infant with IHPS. The typical physical exam findings include visible peristaltic waves and palpation of the olive mass in the upper abdomen. In the absence of a palpable mass, an upper gastrointestinal (UGI) barium study or ultrasonographic evaluation will usually make the diagnosis. Ultrasound is the preferred modality to diagnose IHPS. Demonstration of pyloric muscle thickness of 3.5 mm to 4 mm or more and pyloric channel length of 16 mm or more increases the specificity of the ultrasound to 100%.

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Section: Discussionsupporting

confidence: 90%

Ultrasound Value in the Early Diagnosis and Exclusion of Idiopathic Hypertrophic Pyloric Stenosis: 10 Years Experience at Babylon Governorate

Resheed¹

2017

J Gen Pract

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“…The consensus is that the single most reliable measurement is the transverse pyloric muscle thickness. [3][4][5][6][7]9 In our series we achieved a sensitivity and specificity of 100% using a muscle thickness cutoff of 3 mm. However, ultrasonography is highly operator dependent, and the slightest change in position of a cursor can add or subtract 1 to 2 mm, which obviously can make a large difference in the examination result.…”

Section: Discussionmentioning

confidence: 58%

Pyloric ratio: efficacy in the diagnosis of hypertrophic pyloric stenosis.

Lowe

Banks

Shyr

1999

Journal of Ultrasound in Medicine

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We sought to define a weight independent, highly sensitive and specific measurement to diagnose hypertrophic pyloric stenosis. A retrospective review of 87 children was performed. We determined the pyloric ratio (wall thickness/pyloric diameter) and its relationship to weight and compared it to standard criteria. The average pyloric ratios in normal children and in those with hypertrophic pyloric stenosis were 0.205 and 0.325, respectively (P < 0.001). A pyloric ratio of 0.27 yielded a sensitivity and specificity of 96% and 94%, respectively. The pyloric ratio maintained a linear relationship to weight in normal patients and those with hypertrophic pyloric stenosis. We conclude the pyloric ratio can be a highly sensitive, specific, and weight independent indicator of hypertrophic pyloric stenosis.

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“…A length of the pyloric channel of 14 mm or greater and the thickness of the pyloric muscle of 3 mm or greater are used as sonographic criteria for the diagnosis of infantile hypertrophic pyloric stenosis (Figure 12). 17 …”

Section: Infantile Hypertrophic Pyloric Stenosismentioning

confidence: 99%

Sonography of the Gastrointestinal Tract

Chaubal

Dighe

Shah

et al. 2006

Journal of Ultrasound in Medicine

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Objective. The purpose of this presentation is to provide an overview of sonographic manifestations of various gastrointestinal diseases. Methods. Patients were scanned with an HDI 3000 or HDI 5000 system (Philips Medical Systems, Bothell, WA) with both a 2-to 5-MHz curvilinear transducer and a 5-to 12-MHz linear transducer. The patients were asked to fast from the previous night. For accurate visualization of the stomach, a cup of water was given to patients thought to have stomach or upper gastrointestinal disease. Results. A satisfactory sonographic examination could be performed in all patients. Conclusions. With recent technical advances, the increasing use of sonography in initial evaluation of patients with abdominal pain may allow earlier detection of bowel disease.

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Hypertrophic pyloric stenosis in the infant without a palpable olive: accuracy of sonographic diagnosis.

Abstract: Sonography is highly sensitive and, in this patient population, highly specific, and by virtue of direct visualization of the pyloric muscle, it is the method of choice for both diagnosis and exclusion of pyloric stenosis.

Cited by 131 publications

References 0 publications

Ultrasound Value in the Early Diagnosis and Exclusion of Idiopathic Hypertrophic Pyloric Stenosis: 10 Years Experience at Babylon Governorate

Ultrasound Value in the Early Diagnosis and Exclusion of Idiopathic Hypertrophic Pyloric Stenosis: 10 Years Experience at Babylon Governorate

Pyloric ratio: efficacy in the diagnosis of hypertrophic pyloric stenosis.

Sonography of the Gastrointestinal Tract

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