Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care Ultrasound

Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care Ultrasound

A 15-day-old male who was born at term presented with non-bilious projectile vomiting. He was nontoxic and his abdomen was benign without masses. Point-of-care ultrasound (POCUS) showed hypertrophic pyloric stenosis (HPS). Typical findings include target sign; pyloric muscle thickness greater than t...

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Main Authors: Nicole Dorinzi, Justine Pagenhardt, Melinda Sharon, Kristine Robinson, Erin Setzer, Nicolas Denne, Joseph Minardi
Format: Article
Language:English
Published: eScholarship Publishing, University of California 2017-11-01
Series:Clinical Practice and Cases in Emergency Medicine
Online Access:https://escholarship.org/uc/item/9bx5m1b3
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spelling doaj-6f768934e11148d697a1b7d9a43190d62020-11-24T21:04:40ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2017-11-011410.5811/cpcem.2017.9.35016cpcem-01-395Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care UltrasoundNicole DorinziJustine PagenhardtMelinda SharonKristine RobinsonErin SetzerNicolas DenneJoseph MinardiA 15-day-old male who was born at term presented with non-bilious projectile vomiting. He was nontoxic and his abdomen was benign without masses. Point-of-care ultrasound (POCUS) showed hypertrophic pyloric stenosis (HPS). Typical findings include target sign; pyloric muscle thickness greater than three millimeters (mm); channel length greater than 15–18 mm; and lack of gastric emptying. The patient was admitted; consultative ultrasound (US) was negative, but repeated 48 hours later for persistent vomiting. This second US was interpreted as HPS, which was confirmed surgically. Pyloromyotomy was successful. Few reports describe POCUS by general emergency physicians to diagnose HPS. Here, we emphasize the value in repeat US for patients with persistent symptoms.https://escholarship.org/uc/item/9bx5m1b3
collection DOAJ
language English
format Article
sources DOAJ
author Nicole Dorinzi
Justine Pagenhardt
Melinda Sharon
Kristine Robinson
Erin Setzer
Nicolas Denne
Joseph Minardi
spellingShingle Nicole Dorinzi
Justine Pagenhardt
Melinda Sharon
Kristine Robinson
Erin Setzer
Nicolas Denne
Joseph Minardi
Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care Ultrasound
Clinical Practice and Cases in Emergency Medicine
author_facet Nicole Dorinzi
Justine Pagenhardt
Melinda Sharon
Kristine Robinson
Erin Setzer
Nicolas Denne
Joseph Minardi
author_sort Nicole Dorinzi
title Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care Ultrasound
title_short Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care Ultrasound
title_full Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care Ultrasound
title_fullStr Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care Ultrasound
title_full_unstemmed Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care Ultrasound
title_sort immediate emergency department diagnosis of pyloric stenosis with point-of-care ultrasound
publisher eScholarship Publishing, University of California
series Clinical Practice and Cases in Emergency Medicine
issn 2474-252X
publishDate 2017-11-01
description A 15-day-old male who was born at term presented with non-bilious projectile vomiting. He was nontoxic and his abdomen was benign without masses. Point-of-care ultrasound (POCUS) showed hypertrophic pyloric stenosis (HPS). Typical findings include target sign; pyloric muscle thickness greater than three millimeters (mm); channel length greater than 15–18 mm; and lack of gastric emptying. The patient was admitted; consultative ultrasound (US) was negative, but repeated 48 hours later for persistent vomiting. This second US was interpreted as HPS, which was confirmed surgically. Pyloromyotomy was successful. Few reports describe POCUS by general emergency physicians to diagnose HPS. Here, we emphasize the value in repeat US for patients with persistent symptoms.
url https://escholarship.org/uc/item/9bx5m1b3
work_keys_str_mv AT nicoledorinzi immediateemergencydepartmentdiagnosisofpyloricstenosiswithpointofcareultrasound
AT justinepagenhardt immediateemergencydepartmentdiagnosisofpyloricstenosiswithpointofcareultrasound
AT melindasharon immediateemergencydepartmentdiagnosisofpyloricstenosiswithpointofcareultrasound
AT kristinerobinson immediateemergencydepartmentdiagnosisofpyloricstenosiswithpointofcareultrasound
AT erinsetzer immediateemergencydepartmentdiagnosisofpyloricstenosiswithpointofcareultrasound
AT nicolasdenne immediateemergencydepartmentdiagnosisofpyloricstenosiswithpointofcareultrasound
AT josephminardi immediateemergencydepartmentdiagnosisofpyloricstenosiswithpointofcareultrasound
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