KINDERRADIOLOGIE ONLINE - view radiology images and radiology cases
Lesen Sie diese Seite auf Deutsch   Read this page in English
The Peer Reviewed Pediatric Radiology Platform on the Web
ISSN: 1942-955X :: Publisher: EduRad ::Editor-In-Chief: Roland Talanow, MD, PhD  
Browse Browse || Search Search || Online Book Systematically Online Book Systematically || Discussion Forum Discussion Forum || News News || Submit a Case Submit a Case || Rules Rules |
Most Interesting Cases Most Interesting Cases || "Most Diligent" Authors "Most Diligent" Authors || Case of the Day Case of the Day || Teaching files Teaching files || Links Links |
Newsletter Newsletter || Start Start || Survey Survey || Your Opinion Your Opinion || My Profile My Profile || CME-Credits CME-Credits |
    Pediatric Radiology News / Ads / Jobs Get the Pediatric Radiology News as RSS feed !
    Send us your news or ads for free
  • Current role of body MRI in pediatric oncology.... (Pediatr Radiol)
  • Ultrasound guided placement of the distal catheter in paediatric ventriculoatrial shunts-an appraisa... (Childs Nerv Syst)
  • Severe Radiation Necrosis Successfully Treated With Bevacizumab in an Infant with Low-Grade Glioma a... (Pediatr Blood Cancer)
  • CME Kurs: Paediatric Body MRI

  • CME course: Paediatric Body MRI

  • Universitätsklinikum Jena sucht eine Ärztin/einen Arzt in Weiterbildung in Vollzeit

  • Kinderspital Zürich sucht Oberärztin / Oberarzt (100 %)

  • Kinderradiologische Oberärztin / Oberarzt gesucht

  • 2 Stellen in der Kinderradiologie - 1 Assistenzärztin/Assistenzarzt und 1 Oberärztin/Oberarzt in Voll- oder Teilzeit

  • Senior Paediatric Radiologist in Pediatric Radiology section needed

  • Facharzt als Oberärztin / Oberarzt in Sektion Kinderradiologie gesucht

  • Stellenangebot für Assistenzarzt (m/w) zur Facharztausbildung für RADIOLOGIE und/oder KINDERRADIOLOGIE

  • „Fellow“-Stelle zur Weiterbildung in Pädiatrischer Radiologie am Kinderspital Zürich

  • Fellow-Stelle Pädiatrische Neuroradiologie

  • FFF Kinderradiologie - Muskuloskelettale Radiologie im Kindesalter (Fit für den Facharzt)

  • Assistenzarzt für Kinderradiologe gesucht an Universitätsklinikum Schleswig-Holstein, Campus Kiel

  • Turnusarzt (m/w) in Ausbildung zum Facharzt (m/w) für Radiologie

  • Assistenzarzt (m/w) zur Weiterbildung im Schwerpunkt Kinderradiologie

  • Send us your news or ads for free

    Get the Pediatric Radiology News as RSS feed !


    Radiolopolis

    The dynamic Radiology community for education, research and practice


     

    Go to the top of the page   ID: 20021003170616 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

    Bookmark and Share


    | The Authors | Discussion | Write a Comment to this Case |
    | Evaluate this Case | Recommend this Case to a Colleague |
    | Citation | Similar Cases | Similar Cases in the Internet | Images to this Case |
     
    Hypertrophic pylorus stenosis
    Carsten Bock, C Kunze. Hypertrophic pylorus stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021003170616


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Carsten Bock, C. Kunze (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    8 Weeks  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    GI-Stomach  

     
     Pediatric Radiology CasesMost likely etiology:

    unknown  

     
     Pediatric Radiology CasesHistory:

    8 week old girl, vomiting, starting in the 6th week of life. Spewing and exhausted vomiting (not bilious) almost after every meal.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Non-innate hypertrophy of the sphincter muscle (longitudinal muscle is practically not afflicted), which bulges into the antrum. Pathologically, if the diameter of the pylorus is over 14 mm as well as a length of 16mm (where the length is not the only thing that is important), a pyloric stenosis is noted. The thickness of the muscularis propria must be surpass 4mm in an 8 week old baby; in younger children (4 weeks), the limit of 3 mm is set.

    The illness afflicts, according to literature, one in 500 babies (in our observation, this number is high) and is often familial (6.9% postive family histories, concordance in identical twins), the ratio of boys to girls is 4:1.

    The pathogenesis is unclear. An underdeveloped plexus myentericus, hypoganglionoses as well as a problem in NO-synthetase have been discussed as causes.

    The diagnosis is made, aside from the clinical symptoms, by ultrasound. Depiction of the pylorus horizontally and longitudinally is obligatory (using at least a 7.5 MHz transponder). Next to the above-mentioned criteria, a longer examination time is important, so that one can document the insufficient passage of fluid and air through the pylorus. Noted as indirect signs are: full stomach for more than 2 hours after meals with increased peristalsis (in restless children, hard to differentiate).

    An x-ray examination is seen as obsolete today.  

     
     Pediatric Radiology CasesRadiological findings:


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Pylorus transversal, thickened muscularis (5-6 mm). The ring of muscularis does not frequently appear (like also in this picture) circular and of low echo density.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Pylorus longitudinal. Next to the thickened ring of musculature, the well recognizable "Cervix sign" (protrusion into the antrum) as well as the wall stratification (from within going outward) : hyperechoic layer: initial echo of the mucosal membrane.
    hypoechoic layer: Lamina propria and Muscularis mucosae.
    hyperechoic layer: boundary to the Muscularis propria
    hypoechoic layer: Muscularis propria.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Surgery / Histo  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Since 1912, the pyloromyotomy (Weber-Ramstedt, "extramucosal splitting"): Longitudinal splitting of the muscle with preservation of the mucosal lining, is still done today. The complication rate is small when correctly operated on and the prognosis is good. Symptoms disappear usually right away. Conservative treatment methods are only indicated in light cases without weight loss. Treatment includes smaller meals with concurring spasmolytics.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    Hypertrophic pyloric stenosis was first described in 1887 by Hirschprung and was operted on in 1907 for the first time. Since 1912, the pyloromyotomy (Weber-Ramstedt, "extramucosal splitting"): Longitudinal splitting of the muscle with preservation of the mucosal lining, is still done today.  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    pyloric, stenosis, vomiting, hypertrophic pylorus stenosis, hypertrophic pyloric stenosis, pylorus stenosis, pyloric stenosis, projectile vomiting, pyloromyotomy, pylorus myotomy, Weber-Ramstedt, Hirschprung, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Carsten Bock, C Kunze. Hypertrophic pylorus stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021003170616  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: GI-Stomach
    or in the region: GI
    or in the tissue/organ: Stomach
    or with the etiology: unknown
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Hypertrophic pylorus stenosis
    Carsten Bock, C Kunze. Hypertrophic pylorus stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021003170616


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Hypertrophic pylorus stenosis
    Other cases by these authors:

    Search Carsten Bock in Medline Carsten Bock (9)   
    Search C. Kunze in Medline C. Kunze (3)   

    Hypertrophic pylorus stenosis  
     
    Hypertrophic pylorus stenosis
    Carsten Bock, C Kunze. Hypertrophic pylorus stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021003170616


     
     
    Hypertrophic pylorus stenosis
    Carsten Bock, C Kunze. Hypertrophic pylorus stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021003170616


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    How interesting was this case for you?
    (10 = most interesting || 1 = less interesting)
     
    Hypertrophic pylorus stenosis
    Carsten Bock, C Kunze. Hypertrophic pylorus stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021003170616


     




    Discussion >> Write Comment <<



      There are no comments available regarding this case.





     Write a comment to this case (With * marked fields have to be filled)

    Type in this number: 2826

    Name: *

    E-Mail:

    Website:

    Subject: *

    Text: *




     
      Pediatric Radiology Discussion Get the Pediatric Radiology Discussion as RSS feed !
      To the discussion forum
      To the discussion forum

      Get the Pediatric Radiology Discussion as RSS feed !

      © 2001-2016   www.kinderradiologie-online.de
      In cooperation with © Radiolopolis - Radiology Search - Radiology Teacher - PubMed Reader - Annotate - Radiology Lectures & Tutorials - Radiology Boards Preparation - Pediatric Radiology Links - Pediatric Radiology Information - Emergency Radiology - Lung Cancers - USMLE Forums - Cancer Staging Information - Chest Radiology - Radiology Case Report Journal
      For suggestions and questions: information@kinderradiologie-online.de
      Add this site to your favorites (CTRL+D)