Name : Mehdi
Email : ----------------
Resident : Hussein Soleiman Tabar
Gender : Male
Age : 0
weeks old male infant with vomiting after breast feeding and failure to weight gain.
Imaging Procedures and Findings
In image 1 the stomach is filled with contrast and pyloric canal is elongated and narrowed (the so called ??string signÃ¢?Â). Image 2 shows reflux of barium through G-E junction which is due to increased intragastric pressure.
The etiology of HPS is unknown. It presents with projectile vomiting. Associated clinical findings include weight loss, dehydration, and hypochloremic alkalosis. The age of presentation is typically between 4 and 6 weeks. There is often a family history. It tends to occur in first born male infants (male-to-female ratio 3:1). No imaging is required if an experienced clinician can reliably palpate the hypertrophied pylorus. US has proven to be an accurate method for the diagnosis of HPS and has replaced the barium meal in vomiting infants . Occasionally, if US fails to confirm the diagnosis of HPS or if gastroesophageal reflux (GOR) is the likely diagnosis, a barium meal is performed. The pyloric canal is elongated (??stringÃ¢?? sign) and indents the distal antrum to produce the ??titÃ¢?? deformity. Gastric emptying is delayed and GOR is usually present due to gastric outlet obstruction. Treatment is by pyloromyotomy
Hypertrophic pyloric stenosis
Adam: Grainger & Allison's Diagnostic Radiology, 5th ed