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Enlarged pylorus. The length was 16 mm (upper limit of normal 14 mm), and the muscle thickness was 4 mm (upper limit of normal 3 mm).
This image also shows the “antral nipple sign” - redundant pyloric mucosa protruding into the gastric antrum, and the “cervix sign” - indentation of the pylorus into the fluid-filled antrum. The most telling sign, however, was that no gastric contents were seen to pass through the pylorus at any time during the examination.
Pyloric stenosis affects males 4-5 times more often than females. It occurs between 4-8 weeks of life, and presents with non-bilious projectile vomiting. There may be a positive family history.
Ultrasound findings include:
- target sign: hypertrophied hypoechoic muscle surrounding echogenic mucosa
- elongated pylorus with thickened muscle
- cervix sign
- antral nipple sign
- exaggerated peristalsis
- failure of the pylorus to open