Diagnostic Approach to Pyloric Stenosis

Imaging Modalities

• The American College of Radiology recommends ultrasound as an important tool for evaluating hypertrophic pyloric stenosis in infants, with upper GI series reserved for cases where ultrasound findings are equivocal or negative despite strong clinical suspicion 1, 2
• The European Society of Paediatric and Neonatal Intensive Care guidelines note that a definitive diagnosis of pyloric stenosis should be performed by a pediatric radiologist, with point-of-care ultrasound performed by non-radiologists subject to some disagreement 3, 4

Diagnostic Criteria

• The European Society of Paediatric and Neonatal Intensive Care guidelines recommend that ultrasound examination be performed by a pediatric radiologist for a definitive diagnosis of pyloric stenosis, with characteristic findings including pyloric muscle thickness and canal length 3, 5