Location
Culp Center Ballroom
Start Date
4-25-2023 9:00 AM
End Date
4-25-2023 11:00 AM
Poster Number
93
Faculty Sponsor’s Department
Pediatrics
Name of Project's Faculty Sponsor
John Schweitzer
Competition Type
Competitive
Type
Poster Case Study Presentation
Project's Category
Healthcare and Medicine
Abstract or Artist's Statement
Infantile hypertrophic pyloric stenosis (IHPS) is a disorder characterized by hypertrophy of the pylorus causing obstruction of the gastric outlet. IHPS occurs in 1 to 3.5 per 1000 live births and normally develops between weeks 3 to 5 of age. Patients commonly present forceful, projectile, nonbilious vomiting. The diagnosis is confirmed with ultrasound in which pyloric muscle thickness (PMT) and pyloric canal length (PCL) are measured as less than or equal to 3.0 mm and 14.5 mm, respectively. Definitive treatment is surgicalpyloromyotomy. Similarly, duodenal atresia can cause projectile, nonbilious vomiting. However, it typically presents within the first 24 to 38 hours of birth. If not diagnosed antenatally, then the classic “double bubble sign” on abdominal x-ray or upper GI series is pathognomonic.
In this case study, we discuss a case in which diagnostic imaging leads to the misdiagnosis of a patient presenting with projectile vomiting. Initial presentation, differential diagnosis, and hospital workup will be discussed. We present this case study to raise awareness of the possible misdiagnosis of a common childhood illness due to aberrant radiographic presentation.
Double Bubble Trouble: Misdirection in the Diagnosis of Pyloric Stenosis
Culp Center Ballroom
Infantile hypertrophic pyloric stenosis (IHPS) is a disorder characterized by hypertrophy of the pylorus causing obstruction of the gastric outlet. IHPS occurs in 1 to 3.5 per 1000 live births and normally develops between weeks 3 to 5 of age. Patients commonly present forceful, projectile, nonbilious vomiting. The diagnosis is confirmed with ultrasound in which pyloric muscle thickness (PMT) and pyloric canal length (PCL) are measured as less than or equal to 3.0 mm and 14.5 mm, respectively. Definitive treatment is surgicalpyloromyotomy. Similarly, duodenal atresia can cause projectile, nonbilious vomiting. However, it typically presents within the first 24 to 38 hours of birth. If not diagnosed antenatally, then the classic “double bubble sign” on abdominal x-ray or upper GI series is pathognomonic.
In this case study, we discuss a case in which diagnostic imaging leads to the misdiagnosis of a patient presenting with projectile vomiting. Initial presentation, differential diagnosis, and hospital workup will be discussed. We present this case study to raise awareness of the possible misdiagnosis of a common childhood illness due to aberrant radiographic presentation.