HE ROLE OF ULTRASONOGRAPHY AND UPPER GASTROINTESTINAL SERIES IN THE DIAGNOSIS OF INFANTILE HYPERTROPHIC PYLORIC STENOSIS

Abstract

In our present study , the outcome results of our study done in radiology department, Tanta University Hospital on fifty patients suspected to have Infantile Hypertrophic Pyloric Stenosis , thirty of them proved to have Infantile Hypertrophic Pyloric Stenosis . The aim of our study was the role of ultrasonography and upper gastro-intestinal series in diagnosis of Infantile Hypertrophic Pyloric Stenosis. The age of presentation oflnfantile hypertrophic Pyloric Stenosis ranged from 4-12 week, most of them presented at the age ofr 6-8 week while sex distribution was 4 : 1 male to female. The age of onset in our cases ranged from 5-21 day, mostly at the

. age of 11-15 days after birth.

The main presenting symptoms oflnfantile Hypertrophic Pyloric Stenosis were; persistent non bilious vomiting occurring in 100% of cases, which was projectile in 93.3% of cases and regurgitant in 6.7%, loss of weight in 83.3% while constipation was found in 53.3% of cases. On physical examination, the main diagnostic signs were visible gastric peristaltic waves in 56.6% ofcases and palpable pyloric tumor in 50% of cases.

The ultrasonic measurements of Infantile Hypertrophic Pyloric Stenosis were; pyloric canal length ranged from 18-27.8mm with a mean of 21.4± 2.4 mm. while pyloric diameter ranged from 13.1 - 17mm with a mean of 15 ± 0.7 mm, while pyloric muscle thickness ranged from 4- 6.8mm with a mean of5.2 +0.6 mm..

The radiological signs of Infantile Hypertrophic Pyloric Stenosis were; double track sign (80.3%) ,string sign (76.7%), shoulder sign