Co-existing pyloric submucosal masses with hypertrophic pyloric stenosis (HPS) are very rare and treating these lesions is always a problem. A 20-day-old boy presented with recurrent episodes of projectile non-bilious vomiting lasting for 5 days. HPS was suspected due to the presenting age and the symptoms. The sonography demonstrated not only circumferential wall thickening of the pylorus, but...

OBJECTIVE To assess whether diagnostic imaging of pyloric stenosis has made a difference in rapidity of diagnosis, duration of pre-operative hydration, and length of stay in hospital. DESIGN Chart review of infants with confirmed diagnosis of pyloric stenosis. SETTING Paediatric teaching hospital. SUBJECTS 215 infants with a confirmed diagnosis of pyloric stenosis seen during 1974-7 and 1...

A palpable tumour which contracts and relaxes is generally accepted as conclusive confirmatory evidence of symptoms and signs suggestive of hypertrophic pyloric stenosis in infancy. The writer's experience, in common with that of other workers, is that a contractile tumour is present in 98% of infants with pyloric stenosis examined for the first time over the age of 2 weeks. A detailed study ca...

A 7-week-old white boy presented to the emergency department (ED) with vomiting and weight loss. His parents brought him to the ED 3 weeks earlier after he had vomited for several days. Possible milk protein allergy was diagnosed at that visit, and a change from cow milk formula to an elemental formula was recommended. Vomiting subsequently increased in frequency. Nonbilious but forceful vomiti...

The incidence of pyloric stenosis in the Mersey region rose from 1.54/1000 births in 1976-8 to 2.22/1000 births in 1986-8. Reliance on ultrasonography for diagnosis in the 1980s resulted in fewer 'tumours' being felt; diagnostic delay was not shortened overall but serial ultrasonography showed evolving lesions in six patients. Clinical examination and selective use of ultrasonography is advocated.

Idiopathic hypertrophic pyloric stenosis (IHPS) was thought to be a congenital disease traditionally, even though several published reports assumed IHPS was an acquired disease. The pathogenesis and inheritance patterns of IHPS are not fully understood. Except for the familial recurrence of IHPS, concordance of IHPS in monozygotic or dizygotic twins was also noted, but occurrence in female twin...

338 DR. BARNETT: I think few of us would consider that we know enough new about pyloric stenosis to justify presenting an infant with it to a group of this type. However, the patient to be presented had what appears to be a cornplication of p loric stenosis, which we had not encountered previously and one which is of both practical and theoretic interest. The patient will be described and the d...

Hypertrophic pyloric stenosis is uncommon in premature babies. In term infants, the typical presentations include a palpable mass over the epigastric area, exaggerated gastric peristalsis after feeding and projectile non-bilious vomiting. However these symptoms are not commonly seen in premature infants. The onset of symptoms in pyloric stenosis in premature infants is later than that in term i...

The incidence of infantile hypertrophic pyloric stenosis was measured in the West Midlands Health Region between 1974 and 1980. It increased from 2.1/1000 Caucasian births in 1974 to 3.5/1000 in 1980 and reflects a reported increase in Central Scotland. Several artefacts were excluded--for example, repeat admissions to the same hospital, transfers to other hospitals, and changes in treatment an...

338 DR. BARNETT: I think few of us would consider that we know enough new about pyloric stenosis to justify presenting an infant with it to a group of this type. However, the patient to be presented had what appears to be a cornplication of p loric stenosis, which we had not encountered previously and one which is of both practical and theoretic interest. The patient will be described and the d...