Ghulam Rasul, Mehfooz Ur Rehman, Humayun Iqbal Khan.
Comparative study of pre-operative Sonography with per operative findings in the diagnosis of infantile Hypertrophic Pyloric Stenosis (IHPS).
Pak Paed J Jan ;27(2):74-7.

Objective:- To evaluate comparative pre-operative sonographic accuracy with per operative findings for both diagnosis and exclusion of Infantile Hypertrophic Pyloric Stenosis. Design & setting:- A retrospective sonographic study carried out at Pediatric Radiology Section, Mayo Hospital and Children Hospital Complex Lahore over one year period from December 2001 to February, 2003. Patients & Methods:- To evaluate preoperative sonographic accuracy, real time sonography was performed in 60 infants with suspicion of infantile hypertrophic pyloric stenosis (IHPS), using 5 MHz linear and convex transducer. Precise transverse and longitudinal scans were obtained. They were 48 boys and 12 girls between the age of 2 to 10 weeks with typical projectile persistent nonbilious vomiting after every milk feed. Results:- Over the one year period abdominal ultrasonography was performed in 60 infants for the diagnosis of IHPS. 40(67%) were diagnosed preoperatively as having IHPS on ultrasonography. When compared with operative findings all of these patients had IHPS and pyloromyotomy was performed. All these patients had pyloric muscle thickness > 5mm, pyloric diameter > 15 mm and pyloric canal length more than 17mm. In our study the sensitivity, specificity and overall preoperative sonographoic accuracy in the diagnosis of IHPS was 100% when compared with appropriate surgical referral for pyloromyotomy which have decreased both morbidity and mortality. Conclusion:- Real time sonography is highly sensitive, more specific, cost effective and safe preoperative primary imaging modality for diagnosis of IHPS when compared with per-operative surgical findings.

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