[Ultrasonographic picture of the pylorus in infants].

Abstract

The assessment of pylorus in the diagnostic procedure of causes of vomiting in infants is very important. The differentiation between organic and functional changes is principal. The survey covers 65 infants aged from 2 weeks to 12 months. In this group there are 14 vomiting neonates, in 6 of them the hypertrophic pyloric stenosis by ultrasound examination was diagnosed and by operation confirmed. Ultrasongraphy in presented children was performed on TOMOSONIC EUB--22 Hitachi (real time) provided with a 3 MHz transducer. The pylorus in children is localized near to the middline in the right epigastrium. In normal pylorus the walls of the canal widen the lumen opens. The diameter of normal pylorus amounts 10 to 15 mm, the thickness of muscular wall about 2 mm. In infants with the hypertrophic pyloric stenosis the three components: the muscle, the wall and the lumen of the canal are exceptionally visualized. The hypertrophied muscle forms a regular cylindrical sleeve around the canal and sometimes the pyloric lumen disappears. The diameter of the pyloric mass amounts about 15 to 30 mm and the thickness of the pyloric wall about 5 to 9 mm. The ultrasound examination let to assess the normal pylorus as well as with great probability to diagnose the hypertrophic pyloric stenosis eliminating also in many cases the conventional x-ray examinations.