Pyloric stenosis

Case contributed by Fadi Ali
Diagnosis certain


Non-bilious projectile vomiting

Patient Data

Age: 5 weeks
Gender: Male

Plain radiograph shows marked gaseous distension of the stomach out of proportion to bowel loops.

The chest appears unremarkable.


The pyloric canal showed muscle thickening, measuring about 0.4 cm in thickness, the thickened muscle forms the target sign  (hypoechoic ring of hypertrophied pyloric muscle around echogenic mucosa centrally on transverse images). The canal also appears elongated which is measuring about 1.9 cm in length. 

Case Discussion

The hypertrophic pyloric canal stenosis is the thickening of gastric py­loric musculature which then results in gastric outlet obstruction, happened in male more than female and usually in the first born baby, the ultrasound is the modality of choice with the following criteria, pyloric muscle thickness > 0.3 cm, length > 1.5 cm, transverse diameter > 1.3 cm.

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