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Congenital hypertrophic pyloric stenosis

Case contributed by Tarek Moustafa Essam Daoud
Diagnosis almost certain

Presentation

Vomiting, failure to gain weight.

Patient Data

Age: 1 year
Gender: Male

The pylorus is seen bulky with proximal dilatation of the stomach.

Single muscle layer thickness is seen averaging 5.1 mm. The longitudinal length is seen averaging 19.4 mm.

Slight indentation of the pylorus into the fluid-filled antrum could be seen on examination also known as the cervix sign.

The above features are consistent with hypertrophic pyloric stenosis.

Case Discussion

Congenital hypertrophic stenosis is more common in male neonates. 

It should be suspected in male patients with projectile vomiting and failure to thrive.

Ultrasound is the modality of choice for diagnosis as it is non-invasive with high specificity.

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