Hypertrophic pyloric stenosis

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Persistent vomiting and dehydration.

Patient Data

Age: 1 month
Gender: Male

US of the upper abdomen

ultrasound

Diffuse hypertrophic enlargement of the muscular wall of the pylorus measuring 23 mm in length. It measured 15 mm in width. It measured 7 mm in maximum pyloric muscle thickness during crying.

During crying, the length mildly decreased but the width and muscle thickness mildly increases (thickness increased from 6 mm to 7 mm). This may be due to contraction of pylorus during crying).

Case Discussion

Congenital hypertrophic pyloric stenosis is considered a type of gastric outlet obstruction. It is common in males. It is usually diagnosed if the length is more than 15 mm, width more than 7 mm and muscle thickness more than 3 mm (with variance between studies).

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