Hypertrophic Pyloric Stenosis vs. Gastroesophageal Reflux
Left picture: Further clinical examinations rise the urgent suspicion of hypertrophic pyloric stenosis, which is confirmed by ultrasound. Right picture: Here, the clinical diagnosis is a gastroesophageal reflux, comfirmed by the ongoing pH-metry. A differentiation of the two diagnoses is only possible clinically if in case of hypertrophic pyloric stenosis the characteristic local finding can be detected, e.g. a palpable pyloric tumor; in case of gastroesophageal reflux the diagnosis can clinically only be suspected. Additional examinations are needed to confirm the diagnosis, just as in the reported case the pH-metry.
Both infants are two months old and have a gastric tube introduced through the nose. Left picture: The boy is unhappy and exhibits dry lips and skin folds on the neck. Right picture: This patient of the same age is contented and has no signs of exsiccosis.