Author/Editor		Frković, Marija; Šeronja-Kuhar, Marina; Perhoč, Željka; Barbarić-Babić, Vinka; Molnar, Melita; Vuković, Jurica
Title		Diagnostic imaging of hypertrophic pyloric stenosis (HPS)
Translated title		Slikovna diagnostika hipertrofične pilorične zožitve
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 35, št. 1
Publication year		2001
Volume		str. 11-6
Language		eng
Abstract		Imaging of the abdomen in children with suspected hypertrophic pyloric stenosis has been traditionally performed by plain film radiography and upper gastrointestinal contrast studies. In many clinical situations, this approach has been modified or replaced by ultrasound examination. The authors aimed to analyse the value of diagnostic algorithm in children with hypertrophic pyloric stenosis confirmed at surgery in our hospital. Patients and methods. The authors made a five year retrospective review of hospital records of all children operated on for HPS in Clinical Hospital Centre Zagreb-Rebro and found out that 14 boys, between 2 (17 days) and 10 weeks of life (75 days) underwent surgery due to HPS. Results. Specific radiographic signs were: string sign, double track sign, elongation and narrowing of pyloric, canal, mushroom sign, gastric distension with fluid and beak sign. Ultrasound was performed in 9 patients, one of them was false negative (sonographer admitted that he had no experience), the rest were positive. Conclusions. If the physical examination is negative or equivocal, sonography by an experienced sonographer must be performed. If the ultrasound finding is negative, than the infant should undergo to barium upper gastrointestinal studies (UGI). If HPS is not a primary diagnostic question, it is better to perform UGI first in order to make a correct diagnosis.
Summary		Izhodišče. Rentgensko slikanje trebuha in kontrastna preiskava zgornjih prebavil sta običajni pri otrocih, kjer sumimo na hipertrofično pilorično zožitev. V zadnjem času ju dopolnjuje oziroma zamenjuje ultrazvočna preiskava. Avtorji v prispevku ocenjujejo vrednost diagnostičnega postopka pri otrocih s kirurško potrjeno hipertrofično pilorično zožitvijo. Bolniki in metode. Avtorji so retrospektivno pregledali popise bolnikov, ki so se zdravili v zadnjih petih letih v bolnišnici Rebro zaradi hipertrofične pilorične zožitve in ugotovili, da je bilo zaradi te bolezni operiranih 14 fantov, starih od 2 (17 dni) do 10 tednov (75 dni). Rezultati. Znaki strune (string sign), znaki dvojne sledi (double track sign) zdaljšanje in zožitev piloričnega kanala, znak gobe (mushroom sign), s tekočino izpolnjen želodec ter znak kljuna (beak sign) so se izkazali za značilne diagnostične znake. Devet bolnikov je bilo pregledanih z ultrazvokom; pri enem je bila diagnoza napačno negativna (razlog je bila neizkušenost preiskovalca), vse ostale pa so bile pozitivne. Zakljužek. Če je klinični pregled negativen ali nejasen, je nujno potrebna še ultrazvočna preiskava, ki jo mora opraviti izkušen radiolog-specialist za ultrazvok. V primerih, ko je izvid ultrazvočne preiskave negativen, je potrebno opraviti še kontrastno preiskavo zgornjih prebavil. Kadar pa je diagnostičnih možnosti več, je kot prva na mestu kontrastna preiskava, ki opredeli bolezensko stanje.
Descriptors		PYLORIC STENOSIS CHILD CONTRAST MEDIA BARIUM RADIOISOTOPES HYPERTROPHY