Pyloric Stenosis

Parth C. Patel

Cassandra M. Sams

CLINICAL HISTORY

6-week-old male who presented with projectile, nonbloody, and nonbilious vomiting after every feed for 4 days.

FIGURE 91A

FIGURE 91B

FIGURE 91C

FINDINGS

Figure 91A: Longitudinal ultrasound image of the pylorus demonstrates a thickened pyloric muscle measuring 4.1 mm (between cursors). Figure 91B: Longitudinal ultrasound image of the pylorus shows a markedly thickened, hypoechoic gastric pyloric muscle with an elongated pyloric canal length measuring 17 mm (between cursors). Figure 91C: Transverse US image of the pyloric channel shows the target sign of pyloric stenosis (arrow) because of circumferential hypertrophied hypoechoic muscle surrounding echogenic mucosa.

DIFFERENTIAL DIAGNOSIS

Pylorospasm, gastroesophageal reflux, midgut volvulus, duodenal web/stenosis, annular pancreas, and hypertrophic pyloric stenosis.