Excessive Bright Echoes Sign for Hypertrophic Pyloric Stenosis Suggest the Diagnosis

Gastric Pneumatosis and Portal Venous Gas in Infants Suggest HPS

Harris Cohen, P. Blake Chism, Ina Radtke

Research output: Contribution to journalArticle

Abstract

We describe a new finding, the "excessive bright echoes" sign, for the diagnosis of hypertrophic pyloric stenosis (HPS). Portal venous gas and gastric wall pneumatosis were noted in 4 vomiting infants proven to have HPS. Portal venous gas can be concerning for ischemic bowel. Gastric wall pneumatosis can be seen in association with necrotizing enterocolitis and has been associated with increased gastric pressure from severe, usually proximal, bowel obstruction. Our HPS cases had prominent bright punctate echoes on sonography of the liver, portal vein lumen, and gastric wall. Knowledge of this excessive bright echoes sign suggests the need for sonography of the antropyloric area. One should consider HPS as a differential diagnostic possibility when the combination of bright echoes within the liver parenchyma, consistent with portal venous gas, and bright echoes in the gastric wall, consistent with gastric pneumatosis, are seen.

Original languageEnglish (US)
Pages (from-to)1059-1063
Number of pages5
JournalJournal of Ultrasound in Medicine
Volume36
Issue number5
DOIs
StatePublished - May 1 2017

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Hypertrophic Pyloric Stenosis
Stomach
Gases
Ultrasonography
Necrotizing Enterocolitis
Liver
Portal Vein
Vomiting
Pressure

All Science Journal Classification (ASJC) codes

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Excessive Bright Echoes Sign for Hypertrophic Pyloric Stenosis Suggest the Diagnosis : Gastric Pneumatosis and Portal Venous Gas in Infants Suggest HPS. / Cohen, Harris; Chism, P. Blake; Radtke, Ina.

In: Journal of Ultrasound in Medicine, Vol. 36, No. 5, 01.05.2017, p. 1059-1063.

Research output: Contribution to journalArticle

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