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Virtual Pediatric Hospital: Paediapaedia: Upper GI for Hypertrophic Pyloric Stenosis (HPS) Paediapaedia: Gastrointestinal Procedure Descriptions

Upper GI for Hypertrophic Pyloric Stenosis (HPS)

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Patient Preparation:
None

Contrast:
Barium taken by mouth or nasogastric tube.

Technique:
With the patient supine, flouroscope to observe the motion of the diaphragm.
Put the patient in the left lateral position, and give the patient barium, and take a lateral view of the esophagus.
Put the patient in the supine position, and give the patient barium, and take a supine view of the esophagus.
Put the patient in the right lateral position to empty the stomach.
When contrast is seen to enter the 3rd/4th part of duodenum, turn the patient supine and document the position of the duodenal jejunal junction with a spot film.
Move the patient from right to left lateral and back again to attempt to induce gastroesophagel reflux (Note if you are using a nasogastric tube for the exam, pull it above the gastroesophageal junction before checking for reflux.)
Aspirate the stomach at end of exam if you have a nasogastric tube down.

Views to Take:
AP and lateral views of the esophagus
AP and lateral views of any abnormalities of the antrum
AP view of the Ligament of Treitz

References:
See References Chapter.

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