Postoperative ultrasonography changes of the pylorus in infants with hypertrophic pyloric stenosis

Abstract

Infantile hypertrophic pyloric stenosis (IHPS) is a common condition affecting infants. Ramstedt pyloromyotomy procedure remains the standard of surgical treatment of IHPS till today. Postoperative ultrasonography of the pylorus is indicated in patients with persistent vomiting after pyloromyotomy to assess pyloric morphology, gastric emptying and excludes other associated conditions or complications that may present with this clinical picture. Aim of the work: To assess the short term morphological and dynamic changes of the pyloric muscle following pyloromyotomy in patients with HPS. Subjects and methods: Forty infants who were admitted to the pediatric surgery unit at Tanta university hospitals had a preoperative ultrasound (US) examination for assessment of the pylorus for HPS. Follow up postoperative US was performed on the 3rd day, after 1 week and 1 month by the same radiologist. Results: All the patients showed pyloric measurements that exceeded the agreed upon criteria for diagnosis of HPS. On the postoperative scans the pyloric muscle measurements were recorded and compared to preoperative ones. Conclusion: Postoperative US of the pylorus, with emphasis on the pyloric behavior, is a key tool in assessment of the postoperative changes of the pylorus for patient with surgically treated HPS.

Keywords

• Infantile
• Hypertrophic
• Pyloric stenosis
• Ultrasound
• Postoperative