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Harris L. Cohen, MD, FACR
Ultrasound in the Analysis of the Vomiting Neonate
Harris L. Cohen, MD, FACR
03/08/2010 | Time : 47 min
About This Lecture:

Topics mentioned in this video : Objectives, Case to evaluate – 1982, Pediatric patient waiting for UGI, Water as contrast agent, Gastric schematic, Fluid-aided images, Images were similar to iodinated CT, Fluid-aided ultrasound of luminal pediatric UGI tract Fluid-aided ultrasound of pediatric UGI tract – tips, Fluid-aided ultrasound of pediatric UGI tract – technique for images, Fluid-aided GI ultrasound, ACR task force on appropriateness criteria, Vomiting in the 1st 6 weeks of life, What is vomiting?, Vomiting in the 1st 6 weeks of life: DDx, Clinical and lab findings, Scenario 1, Newborn with bilious vomiting, Bilious vomiting in newborn, Bilious vomiting, Bilious vomiting – UGI series, Normal or abnormal?, Ultrasound, like the GI series, can:, Midgut volvulus Relationship of SMA to SMV, 270 degree rotation, Beware possible midgut volvulus, Newborn with volvulus, CHOP experience, Scenario 2, DDX: chronic vomiting, Regurgitation or GER, Diagnostic work-up for GER, Ultrasound in the work-up for GER Ultrasound to diagnose GER, Vomiting 6 week old – possible pyloric stenosis, Vomiting newborn: any thoughts?, Same patient’s ultrasound, Scenario 3, New onset projectile vomiting – DDx, Hypertrophic pyloric stenosis, HPS: UGI series evaluation, HPS can be diagnosed on UGI, UGI “double track” sign, Teele and Smith – 1977, Bagel or doughnut sign of HPS, Thickened and elongated pylorus in HPS, HPS, HPS: ultrasound length measurements, HPS: ultrasound wall thickness, Continuous trace – correct HPS measuring technique, Ancillary ultrasound signs – HPS, Double track sign – HPS, Mucosal heaping in HPS, So the ultrasound diagnosis of HPS is simple?, Pylorospasm vs. HPS, Pylorospasm – ultrasound findings can simulate those of HPS, Images may vary during exam, Pylorospasm images, Double track sign of pylorospasm, But what about diagnosis by measurement?, Pyloric length in pylorospasm, Ultrasound of pylorospasm, Conclusions re: ultrasound for HPS, Conclusions re: ultrasound for pylorospasm

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Keywords : appendicitis, bagel sign, beak sign, bilious vomiting, bowel ischemia, bowel malrotation, bowel necrosis, caterpillar sign, chronic vomiting, double track sign, doughnut sign, Duodenum, elongated pylorus, gastroenteritis, gastroesophageal junction, GE junction, hiatal hernia, Hirschsprung’s disease, HPS, hypertrophic pyloric stenosis, ileocecal valve, ileus, Intussusception, kernicterus, lactobezoar, Ladd’s bands, ligament of Treitz, meconium plug syndrome, midgut volvulus, mucosal heaping, NEC, necrotizing enterocolitis, neonatal vomiting, pediatric gastroesophageal reflux, pediatric GER, pediatric GERD, pediatric UGI tract, pediatric upper gastrointestinal tract, PEDIATRIC, projectile vomiting, pyloric length, pylorospasm, pylorus, reflux, regurgitation, shoulder sign, SMA, small bowel atresia, small bowel stenosis, small left colon syndrome, SMV, string sign, superior mesenteric artery, superior mesenteric vein, thickened pylorus, UGI, upper GI series

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