Role of Ultrasonography in the Diagnosis of Infantile Hypertrophic Pyloric Stenosis

Abstract

A 28-day-old male baby was brought by his mother with complaints of projectile non-bilious vomitings after feeds, excessive crying, and decreased frequency of stools for three days. The baby was born at full-term by normal vaginal delivery to a primigravida. There was no history of fever/Neonatal Intensive Care Unit (NICU) admission/any significant complication at birth. The family history was unremarkable. The laboratory investigations were within normal limits with no alkalosis or hyperbilirubinemia. The baby was referred to the department of radiology for Ultrasonography (USG). USG showed lengthening of the pyloric canal (measuring 21 mm in length) and thickened hypoechoic pyloric muscle (measuring approximately 5.4 mm in thickness), giving the classic cervix sign on the longitudinal section [Table/Fig-1a] and target of doughnut sign on transverse section [Table/Fig-1b]. A distended stomach was seen proximal to the pylorus [Table/Fig-1c]. These USG features fulfil the criteria for the diagnosis of Infantile Hypertrophic Pyloric Stenosis (IHPS). The diagnosis was confirmed during surgery.

Keywords

• cervix sign
• doughnut sign
• gastric outlet obstruction
• non bilious vomiting
• pyloric muscle