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Pediatr Radiol 2021 Apr 4;51(4):658-668. Epub 2021 Jan 4.

Singleton Department of Radiology, Texas Children's Hospital, 6701 Fannin St., Houston, TX, 77030, USA.

Abdominal US is emerging as an alternative to the upper gastrointestinal (GI) series as the preferred diagnostic imaging test for midgut malrotation complicated by volvulus. Unlike the upper GI series, US is free from ionizing radiation, does not require oral contrast agent, and can be performed portably and at times remotely from the interpreting radiologist, expediting diagnosis. Although some institutions do not have a standardized US protocol for midgut volvulus, many routinely use US in the setting of an infant or child with acute abdominal signs or symptoms to evaluate for common conditions such as hypertrophic pyloric stenosis, intussusception, necrotizing enterocolitis and appendicitis. Read More

Clin Radiol 2021 Mar 20;76(3):163-171. Epub 2020 Oct 20.

Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, United States; Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States.

Term neonatal bowel obstruction is common, and absence of treatment is potentially catastrophic. There is a relatively narrow differential diagnosis, with causes categorised as either low or high bowel obstruction. The commonest causes of low bowel obstruction include anorectal malformations (ARM), Hirschsprung's disease, ileal atresia, meconium ileus, meconium plug, and colonic atresia. Read More

J Med Ultrason (2001) 2020 10 30;47(4):659-660. Epub 2020 Jul 30.

Department of Pediatric Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.

J Surg Case Rep 2020 Jul 20;2020(7):rjaa232. Epub 2020 Jul 20.

Department of Surgery, Douala Gynaeco-Obstetrical and Paediatric Hospital, Douala, Cameroon.

Gastric outlet obstruction encompasses a broad spectrum of conditions characterized by complete or incomplete obstruction of the distal stomach, which interrupts gastric emptying and prevents the passage of gastric contents beyond the proximal duodenum. Idiopathic hypertrophic pyloric stenosis is the most common cause with an incidence of 1.5-3 per 1000 live births. Read More

Pediatr Int 2020 05;62(5):654-655

Pediatric Department, Faculty of Medicine, Saint Vincent De Paul Hospital, Bar Ilan University, Nazareth, Israel.

Pediatr Radiol 2020 07 27;50(8):1102-1106. Epub 2020 May 27.

Department of Radiology and Imaging Sciences, Emory School of Medicine, Atlanta, GA, USA.

Background: Hypertrophic pyloric stenosis (HPS) is a common cause of gastric outlet obstruction in young infants. Infants with HPS present with projectile vomiting, sometimes have electrolyte abnormalities and typically undergo pyloromyotomy to alleviate the obstruction. Abdominal US is the gold standard imaging study for diagnosis. Read More

Clin Imaging 2020 Aug 13;64:103-118. Epub 2020 Mar 13.

University of Maryland Medical Center, Department of Diagnostic Radiology and Nuclear Medicine, 22 South Greene Street, Baltimore, MD 21201, United States.

Ultrasonography is an essential tool in pediatric imaging, particularly in the emergency setting. Although ultrasound is often the favored initial modality for abdominal imaging in children, it is highly operator-dependent and therefore prone to misinterpretation which can lead to false positive or negative exams, or even incorrect diagnoses. Conditions discussed in this series include ileocolic intussusception, hypertrophic pyloric stenosis, appendicitis, and ingested foreign bodies. Read More

Emerg Med J 2020 Jan;37(1):41-49

Emergency Department, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan

Case presentationA 57-year-old man was in a healthy state until 6 hours before presenting to the emergency department, when he suffered from more than 10 episodes of vomiting after a large meal at lunchtime. On physical examination, vital signs were unremarkable. Tenderness was noted over the epigastrium on palpation. Read More

Pediatr Surg Int 2020 Mar 22;36(3):399-405. Epub 2019 Nov 22.

Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, USA.

Purpose: To retrospectively review imaging planes, number of visible pyloric layers and location of measurements, in infants with suspected (HPS).

Methods: 103 pyloric ultrasound studies for suspected HPS were included. For each study, we recorded whether longitudinal or transverse views were performed, the layers visualized (a schematic was developed for two pediatric radiologists to categorize the interfaces of the anatomic layers a-e) and position of the internal measurement cursor. Read More

Clin J Gastroenterol 2020 Feb 26;13(1):60-65. Epub 2019 Jul 26.

Department of Pathology, Akdeniz University Medical School, 07070, Antalya, Turkey.

Adult hypertrophic pyloric stenosis in the form of focal pyloric hypertrophy is an uncommon but a well-established lesion. In most cases, clinical findings suggest malignancy, and despite advances in imaging techniques, preoperative diagnosis is difficult. Herein, an example of focal pyloric hypertrophy is presented with a review of the literature to emphasize the clinicopathological characteristics of this lesion. Read More

S Afr J Surg 2019 Jun;57(2):65

Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa and Department of Surgery, University of KwaZulu Natal, Durban, South Africa.

Background: Infantile hypertrophic pyloric stenosis (IHPS) is the thickening of both muscle layers of the pylorus and is most commonly found in first-born males. It usually presents with projectile, non-bilious vomiting. Late presentation leads to severe dehydration and malnutrition with deranged serum-electrolytes and acid-base imbalance delaying treatment and prolonging hospital stay. Read More

J Pediatr Surg 2019 Nov 18;54(11):2461-2463. Epub 2019 May 18.

46 Whitburn Road, Cleadon, Tyne and Wear SR67QS, United Kingdom. Electronic address:

The age of presentation of reflux symptoms and their self-cure in babies without a sliding hernia parallel those of mild pyloric stenosis of infancy (PS). It is proposed that this is because PS and, at least some cases of reflux, share the same cause-a temporary hold-up at the pyloric sphincter owing to acid provoked hypertrophy of the pyloric sphincter. In support of this theory, the written observations of John Thomson, Pediatrician from Edinburgh, in 1921 and Isabella Forshall, Pediatric Surgeon from Alder Hey Hospital, Liverpool, in 1958 are revisited. Read More

Indian J Pediatr 2019 09 14;86(9):805-816. Epub 2019 Feb 14.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India.

The bowel is a challenging abdominal organ to image. The main reason is the variable location, convoluted morphology and motility. A variety of bowel disorders such as congenital, developmental, inflammatory, infectious and neoplastic lesions can affect children and most of them are either unique to this age group or have a distinct clinico-radiological appearance compared to adults. Read More

J Pediatr 2019 May 2;208:292. Epub 2019 Feb 2.

Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Am Surg 2018 Sep;84(9):e354-e356

BMJ Case Rep 2018 Sep 21;2018. Epub 2018 Sep 21.

Department of Pediatric Surgery, School of Medicine, Harran University, Sanliurfa, Turkey.

Development of hypertrophic pyloric stenosis (HPS) after a few weeks of repair of an oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) is a rare condition in early infancy. Although vomiting or feeding intolerance in operated cases of OA+TOF are attributed to oesophageal stricture, gastro-oesophageal reflux and oesophageal dysmotility, it may also be caused by HPS. Herein, we report a newborn infant who had OA and TOF operation on day 2 of life and diagnosed to have HPS at 15th day of age. Read More

BMJ Case Rep 2018 Jul 5;2018. Epub 2018 Jul 5.

Pediatric Gastroenterology, Stony Brook Children's Hospital, Stony Brook, New York, USA.

Hepatic portal venous gas is the presence of gas within the portal vein and its branches. A 4-week-old male infant presented with 1-week history of non-bloody, non-bilious projectile emesis. Examination was significant for an olive-shaped mass in the abdomen. Read More

J Pediatr Surg 2018 Nov 8;53(11):2279-2289. Epub 2018 May 8.

Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Little Rock, AR 72202.

Purpose: Pediatric surgeon performed bedside ultrasound (PSPBUS) is a targeted examination that is diagnostic or therapeutic. The aim of this paper is to review literature involving PSPBUS.

Methods: PSPBUS practices reviewed in this paper include central venous catheter placement, physiologic assessment (volume status and echocardiography), hypertrophic pyloric stenosis diagnosis, appendicitis diagnosis, the Focused Assessment with Sonography for Trauma (FAST), thoracic evaluation, and soft tissue infection evaluation. Read More

N Engl J Med 2017 Dec;377(24):e33

Hospital Pediatrico Moctezuma, Mexico City, Mexico

Sci Rep 2017 08 25;7(1):9527. Epub 2017 Aug 25.

Department of Medical Ultrasound, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, China.

Congenital Hypertrophic Pyloric Stenosis (CHPS) is a disease condition that is caused as a result of pylorus wall hypertrophy and hyperplasia. In this study, we used color Doppler flow imaging (CDFI) and Doppler artifacts technique to observe the blood flow of hypertrophic pylorus tissue and the dynamic imaging of liquid passing through the pyloric canal in CHPS infants. 65 cases of CHPS infants and 50 infants without CHPS served as control group. Read More

J Matern Fetal Neonatal Med 2018 Oct 27;31(20):2742-2747. Epub 2017 Jul 27.

b Department of Pediatric Surgery , Anhui Provincial Children's Hospital , Hefei , Anhui , China.

Objective: To analyze the clinical and epidemiological features of patients with infantile hypertrophic pyloric stenosis (IHPS) so as to provide scientific evidence for diagnosis and prevention of IHPS.

Methods: We performed a retrospective study of infants with IHPS diagnosed from 2012 to 2015 at Anhui Provincial Children's Hospital. Demographic characteristics and clinical data were collected. Read More

J Pediatr 2017 07;186:40

Tecnologico de Monterrey School of Medicine Monterrey, Nuevo León, Mexico.

J Ultrasound Med 2017 May 10;36(5):1059-1063. Epub 2017 Mar 10.

University of Tennessee/Methodist Healthcare Radiology Residency Program, Memphis, Tennessee, USA.

We describe a new finding, the "excessive bright echoes" sign, for the diagnosis of hypertrophic pyloric stenosis (HPS). Portal venous gas and gastric wall pneumatosis were noted in 4 vomiting infants proven to have HPS. Portal venous gas can be concerning for ischemic bowel. Read More

Gastroenterol Hepatol 2016 Nov 24;39(9):643-645. Epub 2016 Apr 24.

Servicio de Aparato Digestivo, Hospital Universitario de Araba, Vitoria-Gasteiz, Araba, España.

Pediatr Nephrol 2017 09 18;32(9):1521-1523. Epub 2016 Oct 18.

Department of Pediatrics, Hokkaido University Hospital, Kita 15-jo Nishi 7-Chome, Kita Ward, Sapporo City, Hokkaido, Japan.

Pan Afr Med J 2016 2;24:114. Epub 2016 Jun 2.

Department of Paediatrics, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.

A 24-day old female Nigerian neonate presented with protracted vomiting, fever and dehydration but without palpable abdominal tumour or visible gastric peristalsis. There was no derangement of serum electrolytes. The initial working diagnosis was Late-Onset Sepsis but abdominal ultrasonography showed features consistent with the diagnosis of IHPS. Read More

Ultrasound Q 2017 Mar;33(1):77-81

*Department of Radiology, †Division of Ultrasound Radiology, Department of Radiology, and ‡Division of Gastrointestinal Radiology, Department of Radiology, SUNY Downstate Medical Center, Brooklyn, NY.

Adult-onset hypertrophic pyloric stenosis (HPS) is a rare anomaly that can be idiopathic or related to underlying gastric pathology. We describe a case of a 25-year-old man with history of human immunodeficiency virus and osteoglophonic dysplasia who presented with pain and swelling at a gastrostomy site. Computed tomography and upper gastrointestinal barium swallow demonstrated gastric distention and stricture at the distal portion of the gastric antrum. Read More

Semin Pediatr Surg 2016 Aug 10;25(4):219-24. Epub 2016 May 10.

Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Tremona Rd, Southampton SO16 6YD, UK; Faculty of Medicine, University of Southampton, Southampton, UK. Electronic address:

Hypertrophic pyloric stenosis is a common surgical cause of vomiting in infants. Following appropriate fluid resuscitation, the mainstay of treatment is pyloromyotomy. This article reviews the aetiology and pathophysiology of hypertrophic pyloric stenosis, its clinical presentation, the role of imaging, the preoperative and postoperative management, current surgical approaches and non-surgical treatment options. Read More

Pediatr Int 2016 Jul 7;58(7):619-21. Epub 2016 Jul 7.

Division of Pediatric Surgery, Department of Surgery, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.

Infantile hypertrophic pyloric stenosis is the most commonly encountered surgical disease among pediatric patients. Incomplete pyloromyotomy is not uncommon complication of pyloromyotomy. However, recurrent pyloric stenosis is extremely rare. Read More

N Z Med J 2016 Jul 1;129(1437):77-9. Epub 2016 Jul 1.

Department of General Surgery, Taranaki Base Hospital, David Street, New Plymouth, New Zealand.