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Imaging of Infantile Hypertrophic Pyloric Stenosis (IHPS)

  • Marta Hernanz-Schulman
  • Barry R. Berch
  • Wallace W. NeblettIII
Chapter

Key Points

■ In advanced cases, the clinical presentation of IHPS is typical. However, in early cases, the presentation may overlap with other causes of vomiting, particularly gastroesophageal reflux.

■ Clinical examination by palpation of the pyloric mass (olive) is specific but less sensitive than imaging depending on the examiner and may be time consuming (moderate evidence).

■ US is the preferred diagnostic imaging test in experienced hands (moderate to strong evidence).

■ US is highly sensitive and specific to the diagnosis of IHPS, does not require radiation or additional gastric filling, and can be diagnostic within a few minutes. However, it requires operator and diagnostic expertise (moderate evidence).

■ If US is negative, UGI series or nuclear medicine to evaluate for reflux may be necessary, depending on clinically assessed need to document presence and degree of reflux.

■ UGI is effective in diagnosis of IHPS but may be time consuming, utilizes radiation which is of particular concern when fluoroscopic time is lengthy, and requires additional filling of the stomach, with the potential for aspiration.

Keywords

Esophageal Atresia Muscle Thickness Pyloric Stenosis Infantile Hypertrophic Pyloric Stenosis Eosinophilic Gastroenteritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Marta Hernanz-Schulman
    • 1
  • Barry R. Berch
    • 2
  • Wallace W. NeblettIII
    • 3
  1. 1.Department of Diagnostic ImagingVanderbilt Children’s Hospital, Monroe Carell Jr Children’s Hospital at VanderbiltNashvilleUSA
  2. 2.Department of Pediatric SurgeryVanderbilt University School of MedicineNashvilleUSA
  3. 3.Department of Surgery; Department of Pediatric SurgeryVanderbilt University School of MedicineNashvilleUSA

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