THE VALUE OF THE PLAIN FILM ROENTGENOGRAM IN PYLORIC STENOSIS

¹ Associate Professor of Radiology.

The plain supine abdominal roentgenogram was analyzed in 100 cases of proven pyloric stenosis, and the incidence of significant roentgen findings was compared with a control group of 100 clinically suspected cases in which pyloric stenosis was excluded.

Roentgen signs improving the radiologist’s ability to predict pyloric stenosis were determined to center around a large hyperperistaltic stomach ("caterpillar" sign) descending into a relatively gasless lower abdomen. A gastric air outline measuring greater than 7 cm. and an outline extending below L2 were 2 of our most helpful criteria.

In clinically suspected pyloric stenosis, analysis of the plain film abdominal roentgenogram is helpful in individualizing the extent of further roentgenologic study. Approximately one-fourth of pyloric stenosis cases have enough corroborative evidence on their plain film roentgenograms to eliminate the need for further radiologic procedures which have at times led to needless radiation exposure. In the remaining cases the findings are helpful in deciding whether to use only overhead roentgenograms after barium administration or to supplement this with fluoroscopy.

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