Infantile Hypertrophic Pyloric Stenosis: Delays in Diagnosis and Overutilization of Imaging Modalities

Abstract

Infantile Hypertrophic Pyloric Stenosis (IHPS) can usually be diagnosed by the detection of a pyloric olive on examination performed by an experience examiner. In babies with typical symptoms and a palpable olive, no further confirmation of diagnosis is required. We retrospectively reviewed the diagnostic evaluations of 93 consecutive patients with proven IHPS. Many patients who had the diagnosis confirmed on physical examination underwent one or more unnecessary and redundant studies. The performance of these studies was associated with delayed diagnosis and possibly with adverse clinical health problems. An algorithm for management of patients with suspected IHPS is proposed. Prompt examination by an experienced examiner is key to the evaluation of such patients.