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Imaging of Infantile Hypertrophic Pyloric Stenosis (IHPS)

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Evidence-Based Imaging in Pediatrics

Key Points

■ In advanced cases, the clinical presentation of IHPS is typical. However, in early cases, the presentation may overlap with other causes of vomiting, particularly gastroesophageal reflux.

■ Clinical examination by palpation of the pyloric mass (olive) is specific but less sensitive than imaging depending on the examiner and may be time consuming (moderate evidence).

■ US is the preferred diagnostic imaging test in experienced hands (moderate to strong evidence).

■ US is highly sensitive and specific to the diagnosis of IHPS, does not require radiation or additional gastric filling, and can be diagnostic within a few minutes. However, it requires operator and diagnostic expertise (moderate evidence).

■ If US is negative, UGI series or nuclear medicine to evaluate for reflux may be necessary, depending on clinically assessed need to document presence and degree of reflux.

■ UGI is effective in diagnosis of IHPS but may be time consuming, utilizes radiation which is of particular concern when fluoroscopic time is lengthy, and requires additional filling of the stomach, with the potential for aspiration.

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References

  1. Hernanz-Schulman M et al. J Ultrasound Med 1995; 14(4):283–287.

    CAS  PubMed  Google Scholar 

  2. Hernanz-Schulman M et al. Am J Roentgenol 2001; 177(4):843–848.

    CAS  Google Scholar 

  3. Kobayashi H, O‘Briain D, Puri P. J Ped Surg 1994; 29:651–654.

    Article  CAS  Google Scholar 

  4. Kusafuka T, Puri P. Pediatr Surg Int 1997; 12(8):576–579.

    Article  CAS  PubMed  Google Scholar 

  5. Langer JC, Berezin I, Daniel EE. J Pediatr Surg 1995; 30(11):1535–1543.

    Article  CAS  PubMed  Google Scholar 

  6. Malmfors G, Sundler F. J Pediatr Surg 1986; 21(4):303–306.

    Article  CAS  PubMed  Google Scholar 

  7. Ohshiro K, Puri P. J Pediatr Surg 1998; 33(2):378–381.

    Article  CAS  PubMed  Google Scholar 

  8. Ohshiro K, Puri P. Pediatr Surg Int 1998; 13:253–255.

    Article  CAS  PubMed  Google Scholar 

  9. Okazaki T et al. J Ped Surg 1994; 29:655–658.

    Article  CAS  Google Scholar 

  10. Vanderwinden J et al. NEJM 1992; 327:511–515.

    Article  CAS  PubMed  Google Scholar 

  11. Vanderwinden JM et al. Gastroenterology 1996; 111(2):279–288.

    Article  CAS  PubMed  Google Scholar 

  12. Wattchow D et al. Gastroenterology 1987; 92:443–448.

    CAS  PubMed  Google Scholar 

  13. Dodge JA, Karim AA. Gut 1976; 17(4):280–284.

    Article  CAS  PubMed  Google Scholar 

  14. Rollins MD et al. Arch Dis Child 1989; 64(1):138–139.

    Article  CAS  PubMed  Google Scholar 

  15. Callahan MJ et al. Pediatr Radiol 1999; 29(10):748–751 [MEDLINE record in process].

    Article  CAS  PubMed  Google Scholar 

  16. Vanderwinden JM et al. J Pediatr Surg 1996; 31(11):1530–1534.

    Article  CAS  PubMed  Google Scholar 

  17. Schechter R, Torfs CP, Bateson TF. Paediatr Perinat Epidemiol 1997; 11(4):407–427.

    Article  CAS  PubMed  Google Scholar 

  18. Carter CO. Br Med Bull 1976; 32(1):21–26.

    CAS  PubMed  Google Scholar 

  19. Applegate MS, Druschel CM. Arch Pediatr Adolesc Med 1995; 149(10):1123–1129.

    CAS  PubMed  Google Scholar 

  20. White MC et al. J Pediatr Surg 1998; 33(6):913–917.

    Article  CAS  PubMed  Google Scholar 

  21. Campbell BT et al. J Pediatr Surg 2007; 42(12):2026–2029.

    Article  PubMed  Google Scholar 

  22. Pranikoff T et al. J Pediatr Surg 2002; 37(3):352–356.

    Article  PubMed  Google Scholar 

  23. Safford SD et al. J Pediatr Surg 2005; 40(6):967–972; discussion 972–973.

    Article  PubMed  Google Scholar 

  24. Michalsky MP et al. J Pediatr Surg 2002; 37(7):1072–1075; discussion 1072–1075.

    Article  CAS  PubMed  Google Scholar 

  25. Hulka F et al. J Pediatr Surg 1997; 32(11):1604–1608.

    Article  CAS  PubMed  Google Scholar 

  26. Olson AD, Hernandez R, Hirschl RB. J Pediatr Surg 1998; 33(5):676–681.

    Article  CAS  PubMed  Google Scholar 

  27. Touloukian RJ, Higgins E. J Pediatr Surg 1983; 18(4):394–397.

    Article  CAS  PubMed  Google Scholar 

  28. Breaux CW Jr, Hood JS, Georgeson KE. J Pediatr Surg 1989; 24(12):1250–1252.

    Article  PubMed  Google Scholar 

  29. Meuwissen T, Slooff J. Maandschr.v. kindergeneesk 1933; 2:557–569.

    Google Scholar 

  30. Teele RL, Smith EH. N Engl J Med 1977; 296(20):1149–1150.

    Article  CAS  PubMed  Google Scholar 

  31. Grosfeld JL, Coran AG, Fonkalsrud EW (eds.). Pediatric Surgery, 6th ed. Philadelphia: Mosby, 2006.

    Google Scholar 

  32. Godbole P et al. Arch Dis Child 1996; 75(4):335–337.

    Article  CAS  PubMed  Google Scholar 

  33. Macdessi J, Oates R. BMJ 1993; 306:553–555.

    Article  CAS  PubMed  Google Scholar 

  34. Freund H et al. Lancet 1976; 1(7982):473.

    Article  Google Scholar 

  35. Shuman FI, Darling DB, Fisher JH. J Pediatr 1967; 71(1):70–74.

    Article  CAS  PubMed  Google Scholar 

  36. Hernanz-Schulman M et al. Radiology 1994; 193(3):771–776.

    CAS  PubMed  Google Scholar 

  37. Yip WC, Tay JS, Wong HB. J Clin Ultrasound 1985; 13(5):329–332.

    Article  CAS  PubMed  Google Scholar 

  38. Stunden RJ, LeQuesne GW,Little KE. Pediatr Radiol 1986; 16(3):200–205.

    Article  CAS  PubMed  Google Scholar 

  39. Blumhagen JD et al. Am J Roentgenol 1988; 150(6):1367–1370.

    CAS  Google Scholar 

  40. Graif M et al. Pediatr Radiol 1984; 14(1):14–17.

    Article  CAS  PubMed  Google Scholar 

  41. O‘Keeffe FN et al. Radiology 1991; 178(3):827–830.

    PubMed  Google Scholar 

  42. Hernanz-Schulman M. Radiology 2003; 227(2):319–331.

    Article  PubMed  Google Scholar 

  43. Kawahara H et al. Arch Dis Child 2002; 87(1):71–74.

    Article  CAS  PubMed  Google Scholar 

  44. Kawahara H et al. J Pediatr Surg 2005; 40(12):1848–1851.

    Article  PubMed  Google Scholar 

  45. Yamataka A et al. J Pediatr Surg 2000; 35(2):338–341; discussion 342.

    Article  CAS  PubMed  Google Scholar 

  46. Hayashi AH et al. J Pediatr Surg 1990; 25(11):1119–1121.

    Article  CAS  PubMed  Google Scholar 

  47. Khoshoo V et al. J Pediatr Gastroenterol Nutr 1996; 23(4):447–451.

    Article  CAS  PubMed  Google Scholar 

  48. Ramstedt C. Med Klin 1912; 8:1702–1705.

    Google Scholar 

  49. Alain JL, Grousseau D, Terrier G. Surg Endosc 1991; 5(4):174–175.

    Article  CAS  PubMed  Google Scholar 

  50. Fujimoto T et al. J Pediatr Surg 1999; 34(2):370–372.

    Article  CAS  PubMed  Google Scholar 

  51. Hall NJ et al. Ann Surg 2004; 240(5):774–778.

    Article  PubMed  Google Scholar 

  52. Leclair MD et al. J Pediatr Surg 2007; 42(4):692–698.

    Article  PubMed  Google Scholar 

  53. St Peter SD et al. Ann Surg 2006; 244(3):363–370.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Diagnostic Imaging, Vanderbilt Children’s Hospital, Monroe Carell Jr Children’s Hospital at Vanderbilt, 37232, Nashville, TN, USA

    Marta Hernanz-Schulman

  2. Department of Pediatric Surgery, Vanderbilt University School of Medicine, 37232, Nashville, TN, USA

    Barry R. Berch MD

  3. Department of Surgery; Department of Pediatric Surgery, Vanderbilt University School of Medicine, 37232, Nashville, TN, USA

    Wallace W. Neblett III MD (Professor of Pediatric Surgery and Pediatrics, Chairman)

Authors
  1. Marta Hernanz-Schulman
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  2. Barry R. Berch MD
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  3. Wallace W. Neblett III MD
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Corresponding author

Correspondence to Marta Hernanz-Schulman .

Editor information

Editors and Affiliations

  1. Dept. Radiology, Miami Children's Hospital, SW 114 Street 7420, Miami , 33156, U.S.A.

    L. Santiago Medina

  2. Dept. Radiology, Riley Children's Hospital, Barnhill Drive 702 , Indianapolis, 46202-5200, U.S.A.

    Kimberly E. Applegate

  3. Harborview Medical Center, University of Washington, Ninth Avenue 325, Seattle, 98104-2499, U.S.A.

    C. Craig Blackmore

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Hernanz-Schulman, M., Berch, B.R., Neblett, W.W. (2010). Imaging of Infantile Hypertrophic Pyloric Stenosis (IHPS). In: Medina, L., Applegate, K., Blackmore, C. (eds) Evidence-Based Imaging in Pediatrics. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0922-0_30

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  • DOI: https://doi.org/10.1007/978-1-4419-0922-0_30

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