Sonography and color Doppler sonography for monitoring conservatively treated infantile hypertrophic pyloric stenosis.
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.
Riccabona
M
M
Universitätsklinik für Radiologie, Klinische Abteilung für Kinderradiologie, Graz, Austria.
Weitzer
C
C
Lindbichler
F
F
Mayr
J
J
D001286:Atropine Derivatives / Q000627:therapeutic use*; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D006801:Humans; D006984:Hypertrophy; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010276:Parasympatholytics / Q000627:therapeutic use*; D011379:Prognosis; D011707:Pyloric Stenosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018615:Ultrasonography, Doppler, Color
D001286:Atropine Derivatives; D010276:Parasympatholytics; C006649:methylatropine