Breaux C W, Georgeson K E, Royal S A, Curnow A J
Department of Surgery, Children's Hospital of Alabama, Birmingham 35233.
Pediatrics. 1988 Feb;81(2):213-7.
The records of 216 infants who had surgical correction of hypertrophic pyloric stenosis between 1980 and 1984 at the Children's Hospital of Alabama were reviewed. A significant increase in the reliance on upper gastrointestinal roentgenographic series and abdominal sonography for confirmation of the diagnosis of hypertrophic pyloric stenosis was noted in our patients when compared to previous reports. Despite the preoperative presence of a palpable pyloric mass in 192 (89%) of the patients, 174 (81%) had a diagnostic imaging procedure. Similar high rates of imaging studies were noted when the records of patients with hypertrophic pyloric stenosis from 1980 and 1984 were reviewed at three other institutions. Palpation of a hypertrophied pylorus is diagnostic of hypertrophic pyloric stenosis. Careful physical examination makes diagnostic imaging unnecessary in the majority of infants with symptoms suggesting hypertrophic pyloric stenosis. Diagnostic imaging for suspected hypertrophic pyloric stenosis should be used only for those infants with persistent vomiting in whom careful and repeated physical examinations fail to detect a palpable pyloric mass.
回顾了1980年至1984年间在阿拉巴马州儿童医院接受肥厚性幽门狭窄手术矫正的216例婴儿的记录。与之前的报告相比，我们的患者中依赖上消化道X线造影系列和腹部超声来确诊肥厚性幽门狭窄的情况显著增加。尽管192例（89%）患者术前可触及幽门肿块，但仍有174例（81%）进行了诊断性成像检查。当对其他三家机构1980年至1984年肥厚性幽门狭窄患者的记录进行回顾时，也发现了类似的高成像检查率。触及肥厚的幽门可诊断为肥厚性幽门狭窄。对于大多数有肥厚性幽门狭窄症状的婴儿，仔细的体格检查使得诊断性成像没有必要。怀疑肥厚性幽门狭窄的诊断性成像仅应用于那些持续呕吐且仔细反复体格检查未能触及可触及幽门肿块的婴儿。
