All issues > Volume 37(4); 1994

Original Article

J Korean Pediatr Soc. 1994;37(4):494-501. Published online April 15, 1994.

Ultrasonographic Diagnosis of Congenital Hypertrophic Pyloric Stenosis

Chung Hyun CH Yun¹, Kwang Sin KS Kim¹, Young Wook YW Kim¹, Ki Bok KB Kim¹

¹Department of Pediatrics, Kwangju Christian Hospital, Kwangju, Korea

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.

Keywords :Congenital hypertrophic pyloric stenosis, Ultrasonography