High-resolution ultrasound study of morphological changes of the pylorus in the postoperative cases of infantile hypertrophic pyloric stenosis

• Main Authors: Mriganka Guria, Dipak Ghosh, Janki Bisth, Swadha Priya Basu, Kaushik Saha
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2021-01-01
• Series: Journal of Indian Association of Pediatric Surgeons
• Subjects: high-resolution ultrasound pylorus; infantile hypertrophic pyloric stenosis; postoperative pyloric morphology; ramstedt pyloromyotomy
• Online Access: http://www.jiaps.com/article.asp?issn=0971-9261;year=2021;volume=26;issue=2;spage=98;epage=101;aulast=Guria

Aims: The aim of this study was to find & compare the pyloric Canal Length (CL), Pyloric muscle thickness (MT) by using the High Resolution Ultrasonography (HRUS) in Preoperative & postoperative period (after Ramstedt Pyloromyotomy) for Infantile Hypertrophic Pyloric Stenosis (IHPS). Methods: From January 2018 to June 2019, we have performed HRUS for 40 patients of clinically diagnosed cases of IHPS. & Ultrasonography machine: Phillips HD 7 machine & Alpinion E-CUBE with 3-12MHz linear probe, 3.5-5 MHz curvilinear probe and 5-7.5 MHz sector probe were used. The sonographic criteria for positive IHPS are Pyloric muscle thickness (MT) > 3 mm, pyloric Canal length (CL) >14 mm. Postoperative MT & CL at 2 month, 4 month & 6 month were determined and results were analysed with the preoperative pyloric parameters. Statistical analysis used: Mean and standard deviation of values were obtained by using Microsoft excel and statistical significance was analysed by regression study of grouped variables showing p – value by Microsoft excel. Results: Pyloric parameters (MT & CL ) gradually attain normal values over months and 80 % of patients showed resolution of pyloric MT & CL values by 6 months. MT assessment shows statistical significance at six months scan ( p- value <0.05). Conclusions: Serial postoperative HRUS in IHPS cases show gradual ( mostly by 6 months) resolution of pyloric parameters ( MT & CL ) to normal. MT appears to be a consistent parameter for serial assessment.