Application of ultrasonography (USG) was performed to diagnose three pediatric surgical diseases, such as incarcerated inguinal hernia, hypertrophic pyloric stenosis, and intussusception at Gunma Childrens Hospital Medical Center.
1. Use of USG in patients with incarcerated inguinal hernia.
A) The mean diameter of the maximum hernial content was 14.6mm in reducted cases and 20.1mm in operated cases. The minimum hernial content was 7.8mm in reducted and 5.8mm in operated.
The ratio (maximum/minimum) was 2.0 in reducted and 3.5 in operated.
B) Sonographic “reducible sign” was able to observe when the reduction was possible.
2. Use of USG in patients with hypertrophic pyloric stenosis (H.P.S.)
A) The sonographic standard in H.P.S. was more than 14mm in diameter of pyloric canal and more than 3mm in the muscle thickness.
The “stenotic index” (muscle thickness × 2/diameter) was valuable in the diagnosis.
less than 0.30 : normal case
0.31-0.50 : possible case more than 0.51 : definitive case
B) After operation, muscle thickness was decreased from 3.8mm to 2.5mm and stenotic index was changed from 0.53 to 0.35.
C) “Wedge sign”, demonstrated at the portion of pyloromyotomy, was observed immediately after operation and couldn't be seen about 2 weeks later.
3. Use of USG in patients with intussusception.
Sonographic pattern, demonstrated as multiple concentric ring sign, was, valuable to diagnose intussusception.
Measurement of the diameter of the intussuscipiens by ultrasonography was 25.2mm in reducted cases and 30.0mm in operated cases.
The ratio of intussusceptum/intussuscipiens was 0.55 in reducted and 0.41 in operated.
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