A three month old child was presented as an emergency case at the children's department.
For a longer period this child vomits after each meal. Clinical not dehydrated.
CAVE: ( Infantile) Hypertrophic Pyloric Stenosis or ( I) HPS.
Examination in right sided position.
The correct measurement for HPS may vary from article to article.
It is helpful to remenber the first digits of the number pi 3,1415.
- single muscle layer > 3mm
- pyloric transverse diameter > 14 mm
- longitudinal measurement > 15 mm
In this case there was an incorrect measurement what led to a misinterpretation for HPS.
Secondly there was no clear antral nipple sign, this refers to pyloric mucosa protruding into the gastric antrum.
Several minutes later a second look revealed passage of gastric content through the pylorus, distending the antropyloric region.
Now a correct measurement of the single muscle layer amounted to 1,3 mm and a normal longitudinal measurement of 11 mm
Dynamic evaluation is crucial, as a normal passage of gastric content which distends the antropyloric region excludes HPS.
Léon Magis is a highly skilled radiologic technologist renowned for his expertise in medical imaging. Graduating from Fontys University in 1994, he pursued further studies, specializing in musculoskeletal ultrasound in 1998 and completing management training in 2002. His commitment to excellence led him to Emrin Opleidingen, where he obtained certifications in MRI (2006) and cardiac MRI (2012) from Fontys Eindhoven. Joining Flexray in 2016, Magis specializes in ultrasound imaging of the abdomen, neck, genitals, and musculoskeletal system, as well as MRI, particularly in cardiac and stress imaging.
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