title: 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.affiliation: Universitätsklinik für Radiologie, Klinische Abteilung für Kinderradiologie, Graz, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Riccabona
authors.forename: C
authors.initials: C
authors.lastname: Weitzer
authors.forename: F
authors.initials: F
authors.lastname: Lindbichler
authors.forename: J
authors.initials: J
authors.lastname: Mayr
mesh_terms: 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
chemical_list: D001286:Atropine Derivatives; D010276:Parasympatholytics; C006649:methylatropine