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Age: 2 months

Sex: Female

Indication: Vomiting

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Case #5


Findings

  • Stomach is distended with gas and fluid
  • Paucity of bowel gas in the right lower quadrant
  • Overall nonobstructive bowel gas pattern
  • No evidence of free intraperitoneal air
  • Mild bilateral perihilar atelectasis. Lungs are otherwise clear


Diagnosis

  • Pyloric stenosis

Sample Report

Overall nonobstructive bowel gas pattern with a distended stomach and paucity of bowel gas in the right lower quadrant. These are nonspecific findings and ultrasound could provide further evaluation for intussusception or pyloric stenosis if there is clinical concern.

No evidence of free intraperitoneal air.

No abnormal intraabdominal mass effect or calcifications.

Mild bilateral perihilar atelectasis. Lungs are otherwise clear.


Discussion

  • Hypertrophic pyloric stenosis most commonly affects infants age 2-6 weeks old and presents with nonspecific radiographic findings
  • Radiographs may be normal or may show gastric distension, as in this case
  • Ultrasound is key to the diagnosis and in cases of high clinical suspicion, radiographs are not necessary



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