Peds-Gastrointestinal

3 week old with projectile vomiting, POCUS showed positive astral nipple sign which is a highly specific finding for pyloric stenosis - the redundant pyloric mucosa protrudes into the gastric antrum. The measurements show increased pyloric muscle thickness (>3mm) and increased pyloric longitudinal measurement (>15 - 17 mm)

Measurements can be remembered using "Pi Rule"

- Pyloric muscle thickness, i.e. diame­ter of a single muscular wall on a transverse image >3 mm

- Pyloric transverse diameter >14 mm

- Pyloric longitudinal measurement >15 - 17 mm

Contributed by:

Dimitri Livshits DO, Ultrasound Fellow; Jane Belyavskaya MD, Ultrasound Fellow; Chris Hanuscin MD, Ultrasound Division Director (Kings County/SUNY Downstate)

3 week old with projectile vomiting, POCUS showed positive astral nipple sign which is a highly specific finding for pyloric stenosis - the redundant pyloric mucosa protrudes into the gastric antrum. The measurements show increased pyloric muscle thickness (>3mm) and increased pyloric longitudinal measurement (>15 - 17 mm)

Measurements can be remembered using "Pi Rule"

- Pyloric muscle thickness, i.e. diame­ter of a single muscular wall on a transverse image >3 mm

- Pyloric transverse diameter >14 mm

- Pyloric longitudinal measurement >15 - 17 mm

Contributed by:

Dimitri Livshits DO, Ultrasound Fellow; Jane Belyavskaya MD, Ultrasound Fellow; Chris Hanuscin MD, Ultrasound Division Director (Kings County/SUNY Downstate)