2022, Number 4
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Mul Med 2022; 26 (4)
Imaging diagnosis of hypertrophic pyloric stenosis in 119 patients during fifteen years
Mojena MDJ, Diaz ZN, González SMA, Graverán SLA, Mojena MO
Language: Spanish
References: 16
Page:
PDF size: 211.87 Kb.
ABSTRACT
Hypertrophic stenosis of the pylorus is the partial or complete obstruction of the pylorus lumen, its muscles are so strongly thickened that gastric emptying is difficult. Although the diagnosis is basically clinical, imaging studies are decisive to confirm the disease. A retrospective descriptive study was carried out in 119 patients with clinical manifestations of hypertrophic pyloric stenosis, whose diagnosis was confirmed by imaging studies, at the “William Soler” University Pediatric Hospital from 2000 to 2015. The ultrasound measurements were the length of the pyloric channel ≥ 16mm in 95.8%, the wall of the pyloric muscle in 88.2% and pyloric olive diameter in 68.1% of the patients. In 90 children, the diagnosis was done by initial abdominal sonography. The remaining 29 were done barium upper gastrointestinal studies under fluoroscopic vision, observing the string sign in 100%, gastric dilatation in 72.4% and delayed gastric emptying in 58.6%. With a second positive abdominal sonography. Corroborating the diagnosis in the surgical act. Abdominal sonography was a highly positive and sensitive diagnostic study, with the length of the pyloric canal as the main ultrasound measurement and the string sign the major radiological finding.
REFERENCES
Jiménez Vargas MF, Villalobos Romero B, Ching Chacón A. Estenosis hipertrófica del píloro pediátrica. Rev. Méd. Sinerg. 2022;7(6):e831- e8.
Vinycomb T, Vanhaltren K, Pacilli M, Ditchfield M, Nataraja RM. Evaluating the validity of ultrasound in diagnosing hypertrophic pyloric stenosis: a cross-sectional diagnostic accuracy study. ANZ J Surg. 2021; 9(11): 2507-13.
Ruiz YG, Hinojosa AS, García NA, Atuán RF, Rodríguez PB, Pollina JE. Análisis de la estenosis hipertrófica del píloro: el tamaño sí importa. Cir Pediatr. 2017; 30(3): 142-5.
Suihong MA, Jianhua LI, Hongqin WE, Yuwen Y, Shuyi X, Hai JN. Ultrasound in Diagnosis of Congenital Hypertrophic Pyloric Stenosis. Chinese J Medical Imaging. 2018; 26(04): 276-9.
Hernanz Schulman M, Birch BR, Neblett WW. Imaging of Infantile Hypertrophic Pyloric Stenosis (IHPS). En. Medina SL, Applegate EK, Blackmore CC. Evidence-Based lmaging in Pediatrics Optimizing Imaging in Pediatric Patient Care. [Internet]. New York: Springer New York; 2010. p. 447-57. [citado 2/09/2022]. Disponible en: https://link.springer.com/content/pdf/10.1007/978-1-4419-0922-0.pdf5. .
Hernanz Schulman M. Infantile hypertrophic pyloric stenosis. Radiology. 2003; 227(2):319-31.
Sun Park J, Byun YH, Jun Choi S, Sung Lee J, Ryu JM, Lee JY. Feasibility of Point-of-Care Ultrasound for Diagnosing Hypertrophic Pyloric Stenosis in the Emergency Department. Pediatr Emerg Care. 2021; 37(11):550-4.
Leaphart CL, Borland K, Kane TD, Hackam DJ. Hypertrophic pyloric stenosis in newborns younger than 21 days: remodeling the path of surgical intervention. J Pediatr Surg. 2008; 43(6):998-1001.
Sim J, Hong J. Analysis of Ultrasonic Parameters of Pylorus in Idiopathic Hypertrophic Pyloric Stenosis Patients: A Retrospective Study. Adv Pediatr Surg. 2020; 26(1):15-22.
Calle Toro JS, Kaplan SL, Andronikou S. Are we performing ultrasound measurements of the wall thickness in hypertrophic pyloric stenosis studies the same way? Pediatr Surg Int. 2020; 36: 399-405.
Karavdic K, Begic Kapetanovic S, Izmirlic M. Comparison of Pre-Operative Clinical Condition and Values Ultrasound Findings with Postoperative Outcome of Surgical Treatment of Infants with Congenital Hypertrophic Pilorostenosis (CHP). ARC J Surgery. 2018; 4(4):14-21.
Jaafar S, Saeed DM. Clinical findings versus imaging studies in the diagnosis of infantile hypertrophic pyloric stenosis. Ann Pediatr Surg. 2018; 14(1):13-5.
Sobrino JA, Wulkan M. Lesiones del estómago. En: Holcomb GW, Murphy JP, Peter SD. Holcomb y Ashcraf Cirugía Pediátrica. 7 ed. [Internet].Barcelona: Elsevier; 2021. p.478-82. [citado 5/09/2022]. Disponible en: https://www.berri.es/pdf/HOLCOMB%20Y%20ASHCRAFT.%20CIRUG%C3%8DA%20PEDI%C3%81TRICA%E2%80%9A%20Incluye%2050%20V%C3%ADdeos%20(Libro%20+%20eBook)/978849113833413. .
Kelly MM, Cantu C, Richer EJ, Braithwaite KA, Linam LE, Riedesel EL, et al. Incidence and importance of portal venous gas in children with hypertrophic pyloric stenosis. Pediatr Radiol. 2020; 50(8):1102-6.
Daniel S, Francis D, Tobin M, Chawla A. Case of hepatic portal venous gas in an infant with hypertrophic pyloric stenosis. Case Reports. BMJ Case Rep. 2018; 2018: 224794.
Quintero Delgado Z, Cabrera Moya V, Sánchez Martínez L, Cabrera Machado CA, Cortiza Orbe G, Ponce Rodríguez Y. Guía de Práctica Clínica de estenosis hipertrófica del píloro. Rev Cubana Pediatr. 2021; 93(2): e1102-e13.