Presentation
Unsettled child. Frequent vomiting.
Patient Data
There is a prominent gas-filled stomach bubble. Paucity of gas within the small and large bowel is noted.
Targeted ultrasound examination of the epigastrium has been performed. The pylorus is elongated, measuring 22mm in length (normal <15-17mm) with wall thickening (0.46mm, normal <3mm). The pylorus overall is borderline thickened (13mm diameter, upper limit of normal).
The sonographer did not witness normal pylorus opening during the scan duration. Hyperperistalsis of the stomach was observed.
Case Discussion
Case findings are consistent with pyloric stenosis. If possible, reporting radiologists should review the patient in real-time with the sonographer to confirm the dynamic findings of hyperperistalsis of the stomach and non-opening of the pylorus. Infants can also be fed during the examination to try to elucidate normal pyloric opening.
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