Starinsky Ruth, Klin Baruch, Siman-Tov Yariv, Barr Joseph
Department of Radiology, Assaf Harofeh Medical Center, Zerifin 70300, Israel.
Ultrasound Med Biol. 2002 Apr;28(4):421-3. doi: 10.1016/s0301-5629(01)00524-5.
Congenital hypertrophic pyloric stenosis (CHPS) is a common condition in infancy associated with smooth muscle hypertrophy and resulting in pyloric outlet obstruction. The final diagnosis of CHPS is based on precise ultrasonographic measurements of length and width of the pyloric muscle. Based on our clinical and sonographic experience, we observed that smaller measurements of the pyloric muscle were obtained in dehydrated infants than in children examined after proper fluid restoration. The clinical importance of these observations was evident because false-negative results could be obtained. An experimental animal work followed, proving our clinical observation to be true. A significant difference of about 30% to 50% was found between measurements of the muscle thickness of the gastric and pyloric muscles in a state of water deprivation, as compared with a state of full hydration (p < 0.05). Based on our preliminary results, we suggest that children with suspected CHPS should be well hydrated before the ultrasound (US) examination is performed, to avoid false-negative results and a consequent delay in treatment.
先天性肥厚性幽门狭窄（CHPS）是婴儿期的一种常见病症，与平滑肌肥大相关，导致幽门出口梗阻。CHPS的最终诊断基于对幽门肌长度和宽度的精确超声测量。根据我们的临床和超声检查经验，我们观察到，与经过适当补液后检查的儿童相比，脱水婴儿的幽门肌测量值较小。这些观察结果的临床重要性很明显，因为可能会出现假阴性结果。随后进行了实验动物研究，证明我们的临床观察是正确的。与充分补水状态相比，缺水状态下胃肌和幽门肌的肌肉厚度测量值之间存在约30%至50%的显著差异（p<0.05）。根据我们的初步结果，我们建议，对于疑似CHPS的儿童，在进行超声（US）检查前应充分补水，以避免假阴性结果及随之而来的治疗延误。
