Classic triad of an infant 2-8 weeks of age coming with
- Projectile non bilious vomiting
- Oliva like mass palpated
- Hypochloremic metabolic alkalosis
US is the main imaging modality to diagnose pyloric stenosis.
- Find medially to gallbladder
- Rolling the child to right lateral decubitus position and feeding the child with some fluid will make visualization of the pylorus better
Normal appearance in US
In transverse, the thin rim of hypoechoic muscle is typical of a normal Pylorus.
- 2 numbers to remember: 3 and 14 mm
- 3 mm wall thickness (yellow), 14 mm length of pylorus (pink)
- Usually surgical (open or lap pyloromyotomy)
- For those unsuitable, IV or oral atropine maybe used, but it will prolonged hospitalization and follow up.
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