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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
[Personal experience with ultrasonic diagnosis of hypertrophic pyloric stenosis in infants]
G Sarić1, S Simunić, L Pinotić
1Klinicki zavod za radiologiju, Klinicka bolnica Osijek, Branko Rupcić.
Insights
Diagnostic ultrasound is a reliable method for diagnosing infantile hypertrophic pyloric stenosis (IHPS) in infants. This imaging technique avoids radiation exposure, offering a safe alternative to X-rays for pediatric patients.
Area of Science:
- Pediatric Radiology
- Diagnostic Imaging
- Gastroenterology
Background:
- Historically, clinical examination and X-rays were primary methods for diagnosing IHPS.
- Diagnostic ultrasound offers a safer alternative by avoiding ionizing radiation exposure in infants.
Purpose of the Study:
- To evaluate the diagnostic efficacy and reliability of ultrasound in identifying infantile hypertrophic pyloric stenosis (IHPS).
- To assess the role of ultrasound as a primary diagnostic tool for IHPS, reducing reliance on other methods.
Main Methods:
- Retrospective analysis of 12 IHPS cases diagnosed via ultrasound between July 1993 and January 1999.
- Comparison of ultrasound findings with radiological examinations and surgical confirmations where applicable.
Main Results:
- Ultrasound successfully diagnosed 12 cases of IHPS, predominantly in male infants (11/12) aged 5-8 weeks.
- Ultrasound findings were confirmed by surgery in 11 out of 12 operated patients, demonstrating high accuracy.
- In 5 cases, surgery was performed based solely on ultrasound findings, highlighting its diagnostic confidence.
Conclusions:
- Diagnostic ultrasound is a highly reliable and safe imaging modality for IHPS diagnosis in infants.
- Ultrasound can be utilized as a primary diagnostic tool, potentially obviating the need for radiation-based imaging or immediate surgery.
Abstract:
Until wide use of ultrasound in diagnostic procedures took its part, the only relevant procedures to diagnose Infantile Hypertrophic Pyloric Stenosis (IHPS) were clinical examination and X-ray of gastroduodenal tract. Use of diagnostic ultrasound avoids harmful effects of X-rays on immature children's tissues. Reliability of the procedure is very high. In the period between July 1993 and January 1999 we diagnosed 12 cases of IHPS in our Hospital by ultrasound examinations. Eleven patients were males between five and eight weeks of age, and one female was six weeks old. In six of them the finding was confirmed by radiological examination (on surgeon's request), in one neither radiological examination not surgery was performed, and five were operated on the basis of only ultrasound finding. In eleven operated patients ultrasound finding is proven by surgery.
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