Pylorospasm

Mimic/ddx consideration for Infantile hypertrophic pyloric stenosis.

Imaging

Variable pyloric appearance over the exam; relaxes; contrast/contents pass intermittently.
In contrast with IHPS which shows persistent abnormal pylorus across the exam; typically progressive clinical course.

Key differences

• Intermittent functional contraction of the pylorus in irritable infants
• Present with regurgitation/vomiting may mimic reflux but no severe symptoms
• Initial imaging does not fulfil IHPS criteria on initial ultrasound; prolonged observation or repeat scan shows relaxation and resolution.