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Ultrasonographic Diagnosis of Congenital Hypertrophic Pyloric Stenosis

Journal of the Korean Pediatric Society 1994;37(4):494-501.
Published online April 15, 1994.
Ultrasonographic Diagnosis of Congenital Hypertrophic Pyloric Stenosis
Chung Hyun Yun, Kwang Sin Kim, Young Wook Kim, Ki Bok Kim
Department of Pediatrics, Kwangju Christian Hospital, Kwangju, Korea
선천성 비후성 유문협착증의 초음파 진단의 의의
윤충현, 김광신, 김용욱, 김기복
광주기독병원 소아과
Abstract
Ultrasonic evaluation of the pylorus was performed in a group of 22 infants clinically suspected of having Congenital Hypertrophic Pyloric Stenosis (CHPS), from march 1990 to July 1991. In every case the diagnosis of CHPS was confirmed by surgery. Ten normal babies served as the control group. 1) In CHPS group, the mean age on admission was 36.7¡¾16.4 days, and male to female ratio was 19.3. In control group, the mean age was 33.7¡¾18.7 days, with the sex ratio of 8 : 2, male predominating. 2) In CHPS group, the mean age of symptom onset was 18.6¡¾12.7 days, the majority occurring between 2 to 3 weeks (13 cases : 59%). 3) The ultrasonographic measurements showed that the pyloric muscle thickness of CHPS group was 4.94¡¾1.35 mm (mean¡¾S.D), nearly four times greater than that of the control group with 1.30¡¾0.17mm, whereas the pyloric canal length of CHPS group (18.03¡¾1.84mm) was increased significantly, but only by 50%, compared with the control group (11.54¡¾1.70). 4) In CHPS group, operative measurements of pyloric muscle thickness was 5.20¡¾1.23mm, not significantly differing from the sonographic measurement, while pyloric canal length measured 22.13¡¾3.45mm, significantly larger than ultrasonographic measurement. This indicates that the pyloric muscle thickness measured on preoperative ultrasonogram may provide more significant diagnostic value than the pyloric canal length. 5) If the diagnostic criteria for CHPS were taken as pyloric muscle thickness above 4mm and pyloric canal length above 16mm, 21 out of 22 cases (99.4%) were diagnosed correctly.
Key Words: Congenital hypertrophic pyloric stenosis, Ultrasonography


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