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Question: Surgical

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You are seeing a 4 week old infant with non-bilious forceful vomiting x 3 days.

Which of the following findings is most likely how you will diagnose pyloric stenosis?
GIImagingNeonatalSurgery

pemsou5_wp • November 11, 2020


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  1. Kelly November 12, 2020 - 11:43 pm Reply

    C) Pylorus wall measurement of 3mm or greater on ultrasonography
    Ultrasound is the most useful diagnostic test to confirm pyloric stenosis, which should be suspected in infants with projectile non-bilious vomiting of all feeds presenting in the first few months of life (classically presents at age 3-6 weeks). Although palpation of an “olive” is pathognomonic, it is often difficult to palpate. Similarly, hypochloremic metabolic alkalosis is a classic, but late finding. In the modern era, pyloric stenosis is usually diagnosed by ultrasonography. The mnemonic pi-loric, with the number pi being 3.1415, can be used to remember that the ultrasound measurements of concern are: pyloric muscle thickness > 3mm, pyloric transverse diameter > 14mm, and pylorus length > 15mm. UGI barium series is rarely done due to the ease of use and accuracy of ultrasonography.

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