Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Section 3 Cardiac imaging
- Section 4 Vascular and interventional
- Section 5 Gastrointestinal imaging
- Case 44 Ruptured appendicitis mimicking an intussusception
- Case 45 Choledochal cyst
- Case 46 Henoch–Schönlein purpura
- Case 47 Biliary atresia
- Case 48 Mesenchymal hamartoma of the liver
- Case 49 Lymphoid follicular hyperplasia
- Case 50 Midgut volvulus
- Case 51 Foveolar hyperplasia: post prostaglandin therapy
- Case 52 Pneumatosis cystoides intestinalis
- Case 53 Desmoplastic small round cell tumor
- Case 54 Post-transplantation lymphoproliferative disorder
- Case 55 Traumatic pancreatic injury
- Case 56 Meconium ileus
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Case 51 - Foveolar hyperplasia: post prostaglandin therapy
from Section 5 - Gastrointestinal imaging
Published online by Cambridge University Press: 05 June 2014
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgment
- Section 1 Head and neck
- Section 2 Thoracic imaging
- Section 3 Cardiac imaging
- Section 4 Vascular and interventional
- Section 5 Gastrointestinal imaging
- Case 44 Ruptured appendicitis mimicking an intussusception
- Case 45 Choledochal cyst
- Case 46 Henoch–Schönlein purpura
- Case 47 Biliary atresia
- Case 48 Mesenchymal hamartoma of the liver
- Case 49 Lymphoid follicular hyperplasia
- Case 50 Midgut volvulus
- Case 51 Foveolar hyperplasia: post prostaglandin therapy
- Case 52 Pneumatosis cystoides intestinalis
- Case 53 Desmoplastic small round cell tumor
- Case 54 Post-transplantation lymphoproliferative disorder
- Case 55 Traumatic pancreatic injury
- Case 56 Meconium ileus
- Section 6 Urinary imaging
- Section 7 Endocrine - reproductive imaging
- Section 8 Fetal imaging
- Section 9 Musculoskeletal imaging
- Index
- References
Summary
Imaging description
A five-week-old infant presented with projectile vomiting and failure to thrive. There was a prior history of cyanotic congenital heart disease, treated with prostaglandin therapy. On clinical examination, there was no palpable pyloric mass. An ultrasound demonstrated elongation of the pyloric channel without muscular wall thickening, but with markedly prominent hyperechogenic mucosa of the antrum and pylorus (Fig. 51.1a, b). An upper gastrointestinal (GI) fluoroscopy confirmed gastric outlet obstruction with elongation and narrowing of the pyloric channel (Fig. 51.1c, d).
Importance
Prostaglandin therapy can lead to deepening and widening of the gastric fovea (the pits in the mucosa into which gastric glands empty) with hyperplasia and redundancy of the epithelium, especially in the antral and pyloric regions (Figs. 51.1 and 51.2). This “foveolar hyperplasia” can cause obstruction of the gastric outlet, mimicking hypertrophic pyloric stenosis clinically. It is important to differentiate foveolar hyperplasia from hypertrophic pyloric stenosis (Fig. 51.3), since the former is treated conservatively, while the latter is treated with surgical pyloromyotomy.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Pediatric ImagingVariants and Other Difficult Diagnoses, pp. 222 - 225Publisher: Cambridge University PressPrint publication year: 2014