True about CHPS is all except -
Males commonly affected
Commonly presents at 3-8 weeks
X-Ray shows gastric dilation and gasless small intestines
USG is of no use in diagnosis
CHPS Hypertrophy of circular muscle fibers of pylorus with proximal extension into gastric antrum Increase incidence in the firstborn male child with M:F ratio 4:1. Inherited as a dominant polygenic trait. Manifestations: a. The usual age of presentation is 3-6 weeks of life with non-bilious projectile vomiting b. Palpable olive-shaped epigastric mass c. Nasogastric aspirate >10ml d. Positive family history e. Hypochloremic, hypokalemic metabolic alkalosis Upper gi imaging (barium study) Precaution: (1) Empty stomach via nasogastric tube before study (2) Remove contrast at end of the study Barium study features of chps a. Elongation and narrowing of the pyloric canal (2-4 cm length) b. Passing of small barium streak through pyloric canal is seen as a string of barium known as string sign. c. Crowding of muscle folds in pyloric canal known as double/triple track sign. d. Transient triangular tent-like cleft/niche in mid portion of the pyloric canal with the apex pointing inferiorly; e. Outpouching along lesser curvature due to disruption of antral peristalsis, known as pyloric teat/teat sign. f. The mass impression upon antrum with a streak of barium pointing toward the pyloric channel, known as beak sign/antral beaking. g. Indentation of the base of duodenal bulb known as umbrella/kirkling/ mushroom sign. h. Gastric hyperperistaltic waves are known as caterpillar sign. i.Gastric distension with fluid.