Cielma Tara,  Bandarkar Anjum,  Adeyiga Adebunmi

Final Pr. ID: Poster #: EDU-001 (R)

Background: Infantile hypertrophic pyloric stenosis (IHPS) is a condition affecting young infants in which the circular muscle layer of pylorus becomes thickened, leading to narrowing and elongation of the pyloric channel. The pyloric mucosa becomes redundant and appears hypertrophic. On ultrasound, the thickened pylorus is often seen adjacent to the gallbladder and anteromedial to the right kidney. Infants with IHPS are asymptomatic at birth but, in the first few weeks of life, develop nonbilious forceful vomiting described as “projectile emesis” and present with partial gastric outlet obstruction. Surgical pyloromyotomy is curative.
Standard sonographic criteria include measurement of pyloric muscle >3 mm and elongation of pyloric canal >14 mm. Normal pyloric muscle thickness measures <2 mm. When pyloric muscle thickness measures between 2-3 mm, the exam is called as equivocal or borderline. Factors leading to equivocal exam may include incorrect technique that involves over measuring the pyloric muscle thickness, obliquely oriented section of pylorus and transient pylorospasm.
Purpose: The goals of this exhibit are-
1. To review the sonographic anatomy of normal and abnormal pylorus.
2. To illustrate our technical approach to diagnose IHPS with specific attention on how to accurately measure the muscle thickness and channel length.
3. To describe tips and tricks to minimize equivocal exams. Read More

Authors:  Cielma Tara , Bandarkar Anjum , Adeyiga Adebunmi

Keywords:  Infantile hypertrophic pyloric stenosis, ultrasound, muscularis externa