Related Experiment Videos
Value of ultrasound in differentiating causes of persistent vomiting in infants
M D Rollins1, M D Shields, R J Quinn
1Department of Paediatrics, Altnagelvin Area Hospital, Londonderry, Northern Ireland.
Insights
Abdominal ultrasound accurately diagnoses pyloric stenosis in infants with persistent vomiting. This rapid screening method differentiates causes of severe infant vomiting, improving diagnostic speed and accuracy.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
Background:
- Persistent vomiting in infants (5-90 days old) necessitates accurate diagnosis.
- Pyloric stenosis is a common cause of severe infant vomiting.
Purpose of the Study:
- To evaluate the accuracy and reliability of abdominal ultrasound in diagnosing pyloric stenosis.
- To assess ultrasound's utility in differentiating causes of severe infant vomiting.
Main Methods:
- Prospective study of 100 infants with persistent vomiting.
- Cotside abdominal ultrasound after a test feed.
- Comparison with barium examination where necessary.
Main Results:
- Ultrasound diagnosed pyloric stenosis in 44 infants (38 with palpable tumor, 6 without).
- Vomiting resolved in 6 infants without stenosis.
- Barium studies confirmed gastro-oesophageal reflux in 46 infants, with associated conditions in 3.
Conclusions:
- Abdominal ultrasound is an accurate, reliable, and rapid screening tool for infant vomiting.
- Ultrasound effectively differentiates pyloric stenosis from other causes of severe infant vomiting.
Abstract:
A prospective study of abdominal ultrasound was undertaken in 100 consecutive infants who presented with a history of persistent vomiting aged 5 to 90 days. Each infant had a 'test feed' followed by an ultrasonographic scan of the pylorus at the cotside. On test feeding a palpable tumour was evident in 38 infants. On real time ultrasound using the criteria for diagnosing pyloric stenosis, these 38 infants as well as six others were documented as having pyloric stenosis. In the other 56 patients the vomiting settled in six and a barium examination was performed on the remaining 50. This confirmed gastro-oesophageal reflux in 46, two of whom had an associated hiatus hernia, one with a duodenal malrotation, and three were reported as normal. Ultrasound of the abdomen is an accurate, reliable, and rapid screening method to differentiate the causes of severe vomiting in infancy.