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Infantile Hypertrophic Pyloric Stenosis

The Role of Sonography

Glenn A. Rouse, MD

Marie DeLange, RT, RDMS

Diagnostic Ultrasound Department, Loma Linda University Medical Center, Loma Linda, CA 92354

Gerald L. Grube, MD

Infantile hypertrophic pyloric stenosis is an important cause of vomiting in the first 6 weeks of life in a neonate. Because the vomiting can lead to dehydration and electrolyte imbalance, the condition is life-threatening if left untreated. Clinically, the diagnosis of pyloric stenosis is made by palpation of a hard muscular mass about the size of an olive in the upper abdomen. Sonographic diagnosis is based on a pyloric muscle thickness of 0.4 mm or greater and pyloric canal elongation equal to or greater than 1.8 cm. Because sonography offers a direct evaluation of the pylorus and it is noninvasive, it should be recognized as a primary modality in diagnosing infantile hypertrophic pyloric stenosis.

Key Words: pylorus • IHPS • sonography • muscle thickness • pyloric channel elongation

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