Sonogram Before and After Pyloromyotomy: The Pyloric Ratio in Infantile Hypertrophic Pyloric Stenosis
Sonography is used to diagnose infantile hypertrophic pyloric stenosis, but little information is available about the appearance of postoperative sono-graphs. The purpose of this study was to evaluate the morphology of the pylorus in association with an obstruction before and after pyloromyotomy. Me...
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| Format: | Article |
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Elsevier
2009-06-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957209600462 |
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| author | Yu-Lan Huang Hung-Chang Lee Chun-Yan Yeung Wai-Tao Chen Chuen-Bin Jiang Jin-Cherng Sheu Nien-Lu Wang |
| author_facet | Yu-Lan Huang Hung-Chang Lee Chun-Yan Yeung Wai-Tao Chen Chuen-Bin Jiang Jin-Cherng Sheu Nien-Lu Wang |
| author_sort | Yu-Lan Huang |
| collection | DOAJ |
| description | Sonography is used to diagnose infantile hypertrophic pyloric stenosis, but little information is available about the appearance of postoperative sono-graphs. The purpose of this study was to evaluate the morphology of the pylorus in association with an obstruction before and after pyloromyotomy.
Methods: Pyloric length, diameter, muscle thickness and intermuscular space were measured sonographically at diagnosis and daily after pyloromyotomy until discharge in 12 infants with infantile hypertrophic pyloric stenosis. The ratios of pyloric wall thickness and intermuscular space to the entire pyloric diameter were measured.
Results: The pylorus still appeared hypertrophied after pyloromyotomy on the sono-grams. The traditional measurement of linear dimensions of the pylorus was not significantly changed from the preoperative values by the time of discharge, except for muscle thickness. The intermuscular space increased from 4.8 ± 0.8 mm preoperatively to 7.3 ± 2.1 mm by postoperative day 3 (p= 0.10). Lowe's pyloric ratio at diagnosis was a mean of 0.32, decreasing to 0.29 on postoperative day 3 and 0.29 on the day of discharge (p = 0.82). The alternative pyloric ratio increased significantly by postoperative day 2 (0.24 ± 0.09 on day 2 vs. 0.11 ± 0.07 preoperatively, p = 0.02).
Conclusion: The pyloric ratio appears to be a reliable parameter in evaluating the regression of pyloric stenosis after pyloromyotomy, and also aids in the diagnosis of pyloric stenosis. |
| format | Article |
| id | doaj-art-5514f0d754be44f192b1e2bc51e1fbe7 |
| institution | OA Journals |
| issn | 1875-9572 |
| language | English |
| publishDate | 2009-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-5514f0d754be44f192b1e2bc51e1fbe72025-08-20T01:57:28ZengElsevierPediatrics and Neonatology1875-95722009-06-0150311712010.1016/S1875-9572(09)60046-2Sonogram Before and After Pyloromyotomy: The Pyloric Ratio in Infantile Hypertrophic Pyloric StenosisYu-Lan Huang0Hung-Chang Lee1Chun-Yan Yeung2Wai-Tao Chen3Chuen-Bin Jiang4Jin-Cherng Sheu5Nien-Lu Wang6Department of Pediatrics, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Pediatrics, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Pediatrics, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Pediatrics, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Pediatrics, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Pediatric Surgery, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Pediatric Surgery, Mackay Memorial Hospital, Taipei, TaiwanSonography is used to diagnose infantile hypertrophic pyloric stenosis, but little information is available about the appearance of postoperative sono-graphs. The purpose of this study was to evaluate the morphology of the pylorus in association with an obstruction before and after pyloromyotomy. Methods: Pyloric length, diameter, muscle thickness and intermuscular space were measured sonographically at diagnosis and daily after pyloromyotomy until discharge in 12 infants with infantile hypertrophic pyloric stenosis. The ratios of pyloric wall thickness and intermuscular space to the entire pyloric diameter were measured. Results: The pylorus still appeared hypertrophied after pyloromyotomy on the sono-grams. The traditional measurement of linear dimensions of the pylorus was not significantly changed from the preoperative values by the time of discharge, except for muscle thickness. The intermuscular space increased from 4.8 ± 0.8 mm preoperatively to 7.3 ± 2.1 mm by postoperative day 3 (p= 0.10). Lowe's pyloric ratio at diagnosis was a mean of 0.32, decreasing to 0.29 on postoperative day 3 and 0.29 on the day of discharge (p = 0.82). The alternative pyloric ratio increased significantly by postoperative day 2 (0.24 ± 0.09 on day 2 vs. 0.11 ± 0.07 preoperatively, p = 0.02). Conclusion: The pyloric ratio appears to be a reliable parameter in evaluating the regression of pyloric stenosis after pyloromyotomy, and also aids in the diagnosis of pyloric stenosis.http://www.sciencedirect.com/science/article/pii/S1875957209600462infantile hypertrophic pyloric stenosispathogenesispyloric ratiopyloromyotomysonography |
| spellingShingle | Yu-Lan Huang Hung-Chang Lee Chun-Yan Yeung Wai-Tao Chen Chuen-Bin Jiang Jin-Cherng Sheu Nien-Lu Wang Sonogram Before and After Pyloromyotomy: The Pyloric Ratio in Infantile Hypertrophic Pyloric Stenosis Pediatrics and Neonatology infantile hypertrophic pyloric stenosis pathogenesis pyloric ratio pyloromyotomy sonography |
| title | Sonogram Before and After Pyloromyotomy: The Pyloric Ratio in Infantile Hypertrophic Pyloric Stenosis |
| title_full | Sonogram Before and After Pyloromyotomy: The Pyloric Ratio in Infantile Hypertrophic Pyloric Stenosis |
| title_fullStr | Sonogram Before and After Pyloromyotomy: The Pyloric Ratio in Infantile Hypertrophic Pyloric Stenosis |
| title_full_unstemmed | Sonogram Before and After Pyloromyotomy: The Pyloric Ratio in Infantile Hypertrophic Pyloric Stenosis |
| title_short | Sonogram Before and After Pyloromyotomy: The Pyloric Ratio in Infantile Hypertrophic Pyloric Stenosis |
| title_sort | sonogram before and after pyloromyotomy the pyloric ratio in infantile hypertrophic pyloric stenosis |
| topic | infantile hypertrophic pyloric stenosis pathogenesis pyloric ratio pyloromyotomy sonography |
| url | http://www.sciencedirect.com/science/article/pii/S1875957209600462 |
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