PMC10173836_01
Anterior approach to evaluate pyloric stenosis. Usually performed with a high-frequency probe in a transverse plane, start from the subxiphoid point, visualizing the anterior gastric wall, and slide laterally using the liver as an acoustic window. The pylorus is usually slightly right of the midline and caudal to the gallbladder
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F1
With the presumptive diagnosis of gastric outlet obstruction (GOO), an abdominal point-of-care ultrasound (POCUS), [Figure 1] was performed and showed impaired gastric emptying [Figure 2] and a "target sign" (thicker and hypoechoic pyloric muscle surrounding echogenic mucosa on a transverse image), compatible with pyloric stenosis [Figure 3, white arrow].
Ultrasound in the epigastric window, evaluating the gastric content and showing a normal stomach with air artifact (a) and preserved peristalsis compared to an impaired gastric emptying (b) and absence of peristalsis
JMU-31-48-g002.jpg
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F2
With the presumptive diagnosis of gastric outlet obstruction (GOO), an abdominal point-of-care ultrasound (POCUS), [Figure 1] was performed and showed impaired gastric emptying [Figure 2] and a "target sign" (thicker and hypoechoic pyloric muscle surrounding echogenic mucosa on a transverse image), compatible with pyloric stenosis [Figure 3, white arrow].
Normal pylorus (a, arrow) and "Target sign" (b, arrow) in an inflammatory pyloric stenosis on a transverse plane with hypoechogenic muscle edema and a hyperechogenic central mucosa. Even in nonpathological conditions pylorus can be identified in the long axis with its slightly thickened appearance
JMU-31-48-g003.jpg
PMC10173836_01_JMU-31-48-g003.jpg
F3
With the presumptive diagnosis of gastric outlet obstruction (GOO), an abdominal point-of-care ultrasound (POCUS), [Figure 1] was performed and showed impaired gastric emptying [Figure 2] and a "target sign" (thicker and hypoechoic pyloric muscle surrounding echogenic mucosa on a transverse image), compatible with pyloric stenosis [Figure 3, white arrow].