Pyloric stenosis diagnostic study of choice: Difference between revisions

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=== Gold standard/Study of choice: ===
{{CMG}} ; {{AE}} {{MMJ}}
* Ultrasonography is the gold standard test for the diagnosis of pyloric stenosis.
{{pyloric stenosis}}
* The following result of [gold standard test] is confirmatory of [disease name]:
== Overview ==
** Result 1
[[Medical ultrasonography|Ultrasonography]] is the the modality of choice for the diagnosis of infantile pyloric stenosis.The thickened prepyloric antrum bridging the duodenal bulb and distended [[stomach]] and crowded intervening mucosa that protrudes into the distended portion of the [[antrum]] (nipple sign) may be seen in [[Medical ultrasonography|Ultrasonography]] of patients with infantyle pyloric stenosis.
** Result 2
 
* The [name of investigation] should be performed when:
== Diagnostic Study of Choice ==
** The patient presented with symptoms/signs 1. 2, 3.
=== Gold standard of choice: ===
** A positive [test] is detected in the patient.
* [[Medical ultrasonography|Ultrasonography]] is the modality of choice for the diagnosis of infantile pyloric stenosis.<ref name="pmid22696086">{{cite journal| author=Costa Dias S, Swinson S, Torrão H, Gonçalves L, Kurochka S, Vaz CP et al.| title=Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis. | journal=Insights Imaging | year= 2012 | volume= 3 | issue= 3 | pages= 247-50 | pmid=22696086 | doi=10.1007/s13244-012-0168-x | pmc=3369120 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22696086  }} </ref>
* [Name of the investigation] is the gold standard test for the diagnosis of [disease name].
 
* The diagnostic study of choice for [disease name] is [name of investigation].
* The following result of [[ultrasonography]] is confirmatory of infantile pyloric stenosis:
* There is no single diagnostic study of choice for the diagnosis of [disease name].
** Thickened prepyloric antrum bridging the duodenal bulb
* There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
** Distended [[stomach]]
* [Disease name] is mainly diagnosed based on clinical presentation.
** Crowded intervening mucosa that protrudes into the distended portion of the [[antrum]] ('''nipple sign''')<ref name="pmid7602686">{{cite journal| author=Hernanz-Schulman M, Dinauer P, Ambrosino MM, Polk DB, Neblett WW| title=The antral nipple sign of pyloric mucosal prolapse: endoscopic correlation of a new sonographic observation in patients with pyloric stenosis. | journal=J Ultrasound Med | year= 1995 | volume= 14 | issue= 4 | pages= 283-7 | pmid=7602686 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7602686  }} </ref>
* Investigations:
* Hypertrophied hypoechoic muscle surrounding echogenic mucosa may be seen in the ultrasound of patients with infantile pyloric stenosis called '''target sign'''.<ref name="pmid21475495">{{cite journal| author=Hussain M| title=Sonographic Diagnosis of Infantile Hypertrophic Pyloric stenosis- Use of Simultaneous Grey-scale & Colour Doppler Examination. | journal=Int J Health Sci (Qassim) | year= 2008 | volume= 2 | issue= 2 | pages= 134-40 | pmid=21475495 | doi= | pmc=3068743 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21475495  }} </ref>
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
[[File:Pyloric_stenosis_nipple_sign_GIF.gif|500px|thumb|left|Ultrasonography showing pyloric stenosis nipple sign [https://radiopaedia.org/articles/antral-nipple-sign source:Case courtesy of Dr Laughlin Dawes , Radiopaedia.org, rID: 8142]]]
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
<br style="clear:left" />
** Among patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
 
[[File:Hypertrophic-pyloric-stenosis-target sign.jpg|500px|thumb|left|Ultrasonography showing pyloric stenosis target sign [https://radiopaedia.org/cases/51340 source:Case courtesy of Dr Hidayatullah Hamidi, Radiopaedia.org, rID: 51340]]]
<br style="clear:left" />
 
==References==
{{reflist|2}}
{{WH}}
{{WS}}
[[Category:Surgery]]
[[Category:Gastroenterology]]
[[Category:Disease]]
[[Category:Pediatrics]]
[[Category:Up-To-Date]]

Latest revision as of 20:26, 11 December 2017


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

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Overview

Ultrasonography is the the modality of choice for the diagnosis of infantile pyloric stenosis.The thickened prepyloric antrum bridging the duodenal bulb and distended stomach and crowded intervening mucosa that protrudes into the distended portion of the antrum (nipple sign) may be seen in Ultrasonography of patients with infantyle pyloric stenosis.

Diagnostic Study of Choice

Gold standard of choice:

  • Ultrasonography is the modality of choice for the diagnosis of infantile pyloric stenosis.[1]
  • The following result of ultrasonography is confirmatory of infantile pyloric stenosis:
    • Thickened prepyloric antrum bridging the duodenal bulb
    • Distended stomach
    • Crowded intervening mucosa that protrudes into the distended portion of the antrum (nipple sign)[2]
  • Hypertrophied hypoechoic muscle surrounding echogenic mucosa may be seen in the ultrasound of patients with infantile pyloric stenosis called target sign.[3]
Ultrasonography showing pyloric stenosis nipple sign source:Case courtesy of Dr Laughlin Dawes , Radiopaedia.org, rID: 8142


Ultrasonography showing pyloric stenosis target sign source:Case courtesy of Dr Hidayatullah Hamidi, Radiopaedia.org, rID: 51340


References

  1. Costa Dias S, Swinson S, Torrão H, Gonçalves L, Kurochka S, Vaz CP; et al. (2012). "Hypertrophic pyloric stenosis: tips and tricks for ultrasound diagnosis". Insights Imaging. 3 (3): 247–50. doi:10.1007/s13244-012-0168-x. PMC 3369120. PMID 22696086.
  2. Hernanz-Schulman M, Dinauer P, Ambrosino MM, Polk DB, Neblett WW (1995). "The antral nipple sign of pyloric mucosal prolapse: endoscopic correlation of a new sonographic observation in patients with pyloric stenosis". J Ultrasound Med. 14 (4): 283–7. PMID 7602686.
  3. Hussain M (2008). "Sonographic Diagnosis of Infantile Hypertrophic Pyloric stenosis- Use of Simultaneous Grey-scale & Colour Doppler Examination". Int J Health Sci (Qassim). 2 (2): 134–40. PMC 3068743. PMID 21475495.

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