| Significance between Ultrasonographic and Operative Findings in Hypertrophic Pyloric Stenosis |
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Jun Ho Kim1, Woo Taek Kim1, Byeong Ook Jung2 |
1Department of Pediatrics, College of Medicine, Dong-guk University, Kyung-ju, Korea
2Department of General Surgery, College of Medicine, Dong-guk University, Kyung-ju, Korea |
| 비후성 유문 협착증의 초음파적 및 수술적 소견의 의의 |
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김준호1, 김우택1, 정병욱2 |
1동국대학교 의과대학 소아과학교실
2동국대학교 의과대학 일반외과학교실 |
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| Abstract |
Purpose
: The diagnosis of hypertrophic pyloric stenosis(HPS) can be made by clinical manifestations
and upper gastrointestinal(UGI) series in most cases. Recently, the ultrasonogram(US) is a
more accurate and reliable method for the diagnosis of HPS in early stage.
Methods
: We retrospectively studied 27 HPS patients confirmed surgically from January 1999 to
March 2000. We reviewed clinical histories and physical and laboratory findings. Among these patients,
ultrasonograms were carried out in 23 cases preoperatively. Therefore, we analyzed pyloric
muscle thickness(PT), pyloric diameters(PD), and pyloric canal lengths(PL), and calculated pyloric
volume(PV) by the equation of ‘PV=π(1/2PV)2×PL’.
Results
: The mean age on admission was 39.0±20.4 days and 70.4% of the patients were under
6 weeks of age. The mean age at onset was 26.9±20.4 days and the duration of symptoms was
12.7±11.6 days. On physical examination, the pyloric tumors were palpated in 14 cases(51.9%)
and the gastric peristalses were noted in 8 cases(29.6%). UGI series were carried out in 21 cases,
and all of them had the characteristic findings of HPS. The mean PT was 5.23±1.05mm, the mean
PD wase 13.56±2.25mm, the mean PL was 21.42±3.85mm, and the calculated PV was 3.23±1.35
mL. According to the criteria by Stunden, et al., PT(≥4mm), PD(≥12mm) and PL(≥15mm) were
satisfied in 91.3, 73.9 and 91.3% respectively. The PV(≥1.4mL) was satisfied in 95.7% according
to the criterion by Westra, et al.
Conclusion
: The US in the diagnosis of HPS is safe and useful. With measurements of PV parameter,
the diagnosis by US will be more reliable and more accurate. |
| Key Words:
Hypertrophic pyloric stenosis, Ultrasonogram, Operative findings |
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