polkos
Forum Senior
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if the mass is not palpated manually, which test do u advise for diagnosis?
barium meal
ultrasound
x-ray
mri
ct
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| mjl1717
Forum Hero
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Posts: 5,465
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definitive-barium meal, you can see a string sign on Xray(cheaper!!)but rarely required
key words rojectile vomit, palpable hard olive shaped mass,
below 2 years of age, dilated stomach, Ramstedt procedure.
**usmle wants you to be cost effective so I go with-X-ray of stomach using
iodized oil "string sign"(also in Crohns) in the right anterior oblique
position! Barium is not often given to a 2 day old neonate!
good anatomical q! /HY
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| bluedusk
Forum Elite
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it's ultrasound.
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| polkos
Forum Senior
Topics: 7
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ultrasound is noninvasive
barium meal is cheaper
which one is better diagnostic procedure?
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| bluedusk
Forum Elite
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sorry, that was sloppy. i really meant hyper-osmotic but isotonic. k?
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| raddoc
Forum Newbie
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Definitley Ultrasound(US). The " olive" can easily be demonstrated on US and remember this is a newborn who will require several postoperative imaging studies (increase in cumulative radiation dose) if the patient doen't improve, so there is no point in exposing to a cumbersome, semiconclusive procedure like barium which involves radiation. And I don't think barium is really cheaper than US. Also if a good antenatal US was done this could have been picked up. CT and MRI have their obvious adavantages and disadvantages which are really too lengthy to go into. So US is defintely the answer for Congenital Hypertrophic Pyloric Stenosis
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| mjl1717
Forum Hero
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raddoc-I like that reasoning, my info was kind of old. (Come to think of it-Ultrasound as Ive
seen it working as a PA is kind of neat and efficient for morphology like
a hard palpable tumor.) Also I agree I didnt say it before but its hard to think of Barium as costing less then even a portable U.S. Another thing-
I would not be surprised to hear of an overzealous surgeon considering Barium meal! {Between your tech experience and my very minute clinical experience I think this q is answered.-I see now that even in some 3rd world countries an abdominal flat plate would be considered old fashion.
Thx.
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| polkos
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tnx raddoc
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