The stomach is flipped such that the greater curvature is superior to the lesser curvature and the antrum empties inferiorly. There is no obstruction in this asymptomatic 4-month-old.
A. There is no bowel gas beyond the slightly dilated stomach in this newborn with nonbilious vomiting. B. An image from a contrast fluoroscopic study shows complete obstruction at the level of the pylorus. The proximal aspect of the pyloric channel is dilated.
A, B. Anteroposterior and oblique images from a barium upper GI examination show a small-capacity stomach (S) that has a tubular configuration. The duodenal bulb (D) is prominent. There is gastroesophageal reflux.
4. Congenital intrathoracic stomach
Congenital intrathoracic stomach.
An Anteroposterior radiograph of a newborn infant shows the gas-filled stomach to be in the inferior aspect of the mediastinum. The greater curvature is superior, indicating an organoaxial volvulus.
5. Hypertrophic pyloric stenosis
Hypertrophic pyloric stenosis.
An oblique radiograph of the upper portion of the abdomen of a 7-week-old infant shows prominent peristaltic contractions in a dilated stomach. This is the "caterpillar sign."
An abdominal radiograph of a 29-day-old infant with a 3-day history of projectile vomiting shows linear gas collections in the stomach wall (arrows). The stomach is distended. There is a paucity of distal bowel gas.
7. Hypertrophic pyloric stenosis
Hypertrophic pyloric stenosis.
A steep oblique image shows elongation and narrowing of the pyloric channel, the string sign. There is a curved configuration of the pylorus, the J sign. There is a "beak" of contrast at the entrance of the pylorus. Impression on the antrum by the pyloric muscle produces the shoulder sign (arrow).
8. Hypertrophic pyloric stenosis; the double string sign
Hypertrophic pyloric stenosis; the double string sign.
An oblique barium fluoroscopic image shows 2 thin channels of contrast (arrow) within the elongated pylorus.
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