Radiology in the diagnosis of hypertrophic pyloric stenosis.

Paterson (1937), for example, merely states that 'resort to x-rays settles the diagnosis definitely ' without giving any idea of the special features which are of diagnostic importance. Pearson and Wyllie (1935) can also be classed with those who believe that radiology is of considerable value in the diagnosis of hypertrophic pyloric stenosis, since they write that by its use 'pyloric stenosis, if present, can usually be demonstrated.' These latter wvriters do admit, however, that this method of investigation is ' not generally a necessary procedure for diagnosis, but,' they continue, 'it is of value as an aid to the differential diagnosis of pyloric stenosis and pylorospasm.' The sole diagnostic indication from the radiological point of view given by Pearson and Wylie is that in ' stenosis little or nothing leaves the stomach for hours,' since ' normally immediately after a meal food begins to leave the stomach, which is completely emptied in three hours.' Sheldon (1937) is another author who gives almost similar diagnostic indications, since he writes that ' the stomach (in hypertrophic pyloric stenosis) is not empty after three or four hours.' Teal (1933) also considers that ' the results of the radiological investigation in infantile pyloric stenosis are reliable' and gives as the diagnostic features, ' no passage of the meal into the duodenum within 4 hour' and ' the opaque meal remaining in the stomach for six hours.' Parsons and Barling (1933) speak of the radiological examination being valuable in two ways, viz. by providing ' an accurate idea of the size of the stomach ' (although the real use of this information is not stated), and in addition by being the' best means of observing the rate of emptying of the stomach' (but the degree of delay which is indicative of stenosis is not mentioned).