Sonography and color Doppler sonography for monitoring conservatively treated infantile hypertrophic pyloric stenosis.

Abstract

OBJECTIVE:

To evaluate the role of sonography in infants with hypertrophic pyloric stenosis undergoing conservative medical treatment.

METHODS:

Twenty-two infants (17 male and 5 female; age range, 1-12 weeks) were clinically and sonographically considered suitable for conservative treatment and underwent follow-up during the course of the disease. Sonography was performed under a standardized protocol and included color Doppler sonography.

RESULTS:

Fifteen infants (mean age, 9 weeks) needed surgery. They initially had a mean pyloric length of 18 mm, a diameter of 10.5 mm, and a wall thickness of 4 mm, with visible passage of food into the duodenum. These values deteriorated during follow-up (mean preoperative values: length, 20 mm; diameter, 12 mm; and wall thickness, 4.5 mm); furthermore, passage of food through the pyloric canal ceased. Seven infants (mean age, 3 weeks) were successfully treated conservatively Their initial mean pyloric measurements were slightly smaller (length, 15 mm; diameter, 10 mm; and wall thickness, 3.8 mm) and did not deteriorate during follow-up. In all of them, sonography showed improvement of passage through the pyloric canal within several days, as shown and documented by color Doppler sonography; morphologic changes persisted longer despite clinical improvement.

CONCLUSIONS:

Sonography, including color Doppler sonography, is a valuable tool for monitoring infants with hypertrophic pyloric stenosis undergoing conservative treatment; however, initial sonograms cannot predict the further course of the disease.

• Authors: M Riccabona, C Weitzer, F Lindbichler, J Mayr
• Journal: Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine (J Ultrasound Med) Vol. 20 Issue 9 Pg. 997-1002; quiz 1003 (Sep 2001) ISSN: 0278-4297 [Print] England
• PMID: 11549161 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Atropine Derivatives
• Parasympatholytics
• methylatropine

Topics

• Atropine Derivatives (therapeutic use)
• Drug Monitoring (methods)
• Female
• Humans
• Hypertrophy
• Infant
• Infant, Newborn
• Male
• Parasympatholytics (therapeutic use)
• Prognosis
• Pyloric Stenosis (diagnostic imaging, drug therapy)
• Ultrasonography, Doppler, Color