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• W2017259488 abstract "The purpose of this paper is to review briefly the technic, findings, and limitations of the standard method of x-ray diagnosis of infantile hypertrophic pyloric stenosis and to describe a simple maneuver designed to increase the speed and accuracy of the examination. Standard Method of Examination (1–20) Technic: Fasting of four or more hours prior to the examination is usually recommended. Preliminary films of the abdomen are useful but not indispensable. Aspiration of all gastric content prior to the examination is generally advised. Barium is the most commonly used contrast material, and may be administered either by means of a nursing bottle or through a nasogastric tube. The examination is carried out with the patient in the prone position and the left side slightly raised. The stomach and duodenum are studied either by intermittent fluoroscopy and “spot” films, or by a short period of fluoroscopic observation followed by radiographs of the abdomen at regular intervals until the diagnosis is established. Technic: Fasting of four or more hours prior to the examination is usually recommended. Preliminary films of the abdomen are useful but not indispensable. Aspiration of all gastric content prior to the examination is generally advised. Barium is the most commonly used contrast material, and may be administered either by means of a nursing bottle or through a nasogastric tube. The examination is carried out with the patient in the prone position and the left side slightly raised. The stomach and duodenum are studied either by intermittent fluoroscopy and “spot” films, or by a short period of fluoroscopic observation followed by radiographs of the abdomen at regular intervals until the diagnosis is established. Two additional important roentgen signs of hypertrophic pyloric stenosis are the “shoulder” sign in the antrum (Fig. 1), and the “shoulder” or “mushroom” sign in the base of the duodenal cap. These are produced by a slight protrusion of the muscle “tumor” into the lumen of the antrum and into the duodenal cap, respectively, and consist of two smooth concavities or imprints, one above and one below the narrowed and elongated pyloric and prepyloric canal. A fairly common but less specific roentgen finding is of an upward projection of the contrast material in the distal antrum (Fig. 1, B). It probably represents the recess formed by the proximal end of the muscle tumor and the lesser curvature wall of the stomach. This sign has been pointed out by a number of authors in the past and has been more fully described recently under the term of “pyloric tit” (14, 15). Gastric dilatation, paucity or absence of intestinal gas beyond the stomach, gastric hyperperistalsis or atony, undue gastric retention of formula (more than two to three hours), delayed opening of the pylorus, and delayed gastric emptying of the contrast material are other common findings in hypertrophic pyloric stenosis, but although suggestive of obstruction they cannot be considered diagnostic." @default.
• W2017259488 created "2016-06-24" @default.
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• W2017259488 date "1964-11-01" @default.
• W2017259488 modified "2023-10-14" @default.
• W2017259488 title "The Value of Double-Contrast Examination of the Stomach with Pressure “Spots” in the Diagnosis of Infantile Hypertrophic Pyloric Stenosis" @default.
• W2017259488 doi "https://doi.org/10.1148/83.5.873" @default.
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