Infantile hypertrophic pyloric stenosis is an important cause of vomiting in the first 6 weeks of life in a neonate. Because the vomiting can lead to dehydration and electrolyte imbalance, the condition is life-threatening if left untreated. Clinically, the diagnosis of pyloric stenosis is made by palpation of a hard muscular mass about the size of an olive in the upper abdomen. Sonographic diagnosis is based on a pyloric muscle thickness of 0.4 mm or greater and pyloric canal elongation equal to or greater than 1.8 cm. Because sonography offers a direct evaluation of the pylorus and it is noninvasive, it should be recognized as a primary modality in diagnosing infantile hypertrophic pyloric stenosis.
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