Infantile hypertrophic pyloric stenosis: Delays in diagnosis and overutilization of imaging modalities

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 diag nostic evaluations of 93 consecutive patients with proven IHPS. Many patien ts who had the diagnosis confirmed on physical examination underwent one or more unnecessary and redundant studies. The performance of these studies w as associated with delayed diagnosis and possibly with adverse clinical hea lth problems. An algorithm for management of patients with suspected IHPS i s proposed. Prompt examination by an experienced examiner is key to the eva luation of such patients.