Ultrasound evaluation of the stomach and pylorus in the neonate and baby

Advances in ultrasound technology and development of higher frequency transducers have enabled ultrasound to have a greater role in the evaluation of stomach pathology in children.1 Since Teele and Smith first described the use of ultrasound in the diagnosis of hypertrophic pyloric stenosis (HPS) in five infants in 1977, ultrasound has been the examination of choice for diagnosis of HPS and in most institutions has completely replaced fluoroscopy for this purpose.2 The obvious advantage of using ultrasound is the avoidance of ionising radiation. Another advantage of ultrasound is its ability to provide valuable information about the stomach wall and surrounding structures. It is important to recognise the many sonographic appearances of the normal stomach so that they are not interpreted as some sort of pathology. The principal aim of this article is to describe the normal and pathologic appearances of the neonatal stomach and potential interpretation pitfalls. Sonographic technique as performed in our institution is also briefly described.