Time to stop upper gastrointestinal studies for pyloric stenosis
DOI:
https://doi.org/10.18203/2349-3291.ijcp20162414Keywords:
Pyloric stenosis, Ultrasonography, Upper gastrointestinal barium studyAbstract
We refer to the case series on pyloric stenosis.1 The authors selected 25 of IHPS patient prospectively with data regarding history, examination, operation and full follow up with time. In the study, 48% of patients had no signs of dehydration, 36 % had no electrolyte abnormalities, and none had urinary pH abnormality. With widespread availability of health care, late presentation of pyloric stenosis is less common. More babies present early with one or fewer days of vomiting with no evidence of dehydration, electrolyte abnormalities or urinary paradoxical aciduria. However, sensitivity of presence of palpable pyloric mass whose sensitivity was reported to be up to 85% has reduced to 15.5% probably due to early presentation, decreasing clinical skill and increased use of imaging.References
Kumar A, Gupta UK, Gupta P, Singh SP, Gupta M, Singh P, et al. Study of clinical, biochemical evaluation and outcome in hypertrophic pyloric stenosis. Int J Contemp Pediatr. 2016;3(2):473-6.
Tunell WP, Wilson DA. Pyloric stenosis diagnosis by real time sonography, the pyloric muscle length method. J Pediatr Surg. 1984;19:795-8.
Macdessi J, Oates RK. Clinical diagnosis of pyloric stenosis: a declining art. BMJ. 1993;306(6877):553-5.
Niedzielski J, Kobielski A. Accuracy of sonographic criteria in the decision for surgical treatment in infantile hypertrophic pyloric stenosis. Arch Med Sci. 2011;7(3):508-11.
Dias SC, Swinson S, Torrão H, Gonçalves L, Kurochka S, Vaz CP, et al. Hypertrophic pyloric stenosis: tips and tricksfor ultrasound diagnosis. Insights Imaging. 2012;3:247-50.
Khatami A, Ghoroubi J, Imanzadeh F, Attaran F, Mehrafarin M, Sohrabi MR. Olive Palpation, Sonography and Barium Study in the Diagnosis of Hypertrophic Pyloric Stenosis: Decline in Physicians’ Art. Iran J Radiol. 2009;6(2):87-91.