All issues > Volume 44(4); 2001

Original Article

J Korean Pediatr Soc. 2001;44(4):426-432. Published online April 15, 2001.

Significance between Ultrasonographic and Operative Findings in Hypertrophic Pyloric Stenosis

Jun Ho JH Kim¹, Woo Taek WT Kim¹, Byeong Ook BO 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

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.

Keywords :Hypertrophic pyloric stenosis, Ultrasonogram, Operative findings