[Imaging diagnosis of infantile hypertrophic pyloric stenosis: report of a case and review of the literature]. / Diagnóstico por imagen en la estenosis hipertrófica del píloro en la infancia: reporte de un caso y revisión de la literatura.

Infantile hypertrophic pyloric stenosis (IHPS) is familiar to most pediatric and general practitioners, it is a pathology where the radiologist nowadays has a key role confirming the clinical suspicion based in ultrasound and upper-gastrointestinal barium examinations. There is hypertrophy and hyperplasia of the antropyloric portion of the stomach, which becomes abnormally thickened, it manifests as obstruction to gastric emptying. Infants with IHPS are clinically normal at birth, but they develop a nonbilious forceful vomiting during the first weeks of postnatal life, which is described as "projectile". Surgical treatment is curative. The clinical diagnosis hinges on palpation of the thickened pylorus. Imaging findings include the "string sign" (elongation of the pyloric canal) and the "double-track sign" (presence of linear tracts of contrast material separated by the intervening mucosa) on fluoroscopic observation. Sonographic examination demonstrates the thickened prepyloric antrum bridging the duodenal bulb and distended stomach. We present the case of a 26-days-old infant with IHPS; presenting this case we make a brief review of the clinical features and main imaging findings of IHPS.

Imaging diagnosis of subclavian steal syndrome secondary to Takayasu arteritis affecting a left-side subclavian artery.

Takayasu arteritis (TA) is a rare form of large-vessel, chronic, occlusive vasculitis. It involves mainly aorta and its main branches, causing stenosis and/or obstruction. Its frequency has been estimated at 2.9 cases per 1 million people. Epidemiologically, it is found principally in young female patients and is more prevalent in Asia and Latin America. When there is severe stenosis or occlusion in subclavian artery, the phenomenon of subclavian steal syndrome (SSS) occurs, which usually causes symptoms of the vertebrobasilar territory because blood supply to the arm is sustained by reversal of flow in ipsilateral vertebral artery. We describe a case of SSS thought to be due to TA in a Mexican woman. Doppler ultrasound of neck vessels showed retrograde flow in left vertebral artery during systole. Digital subtraction angiography confirmed 30% stenosis of left subclavian artery with filling of left vertebral artery in retrograde direction. In presenting this case, we carried out a brief review of TA, main features in imaging diagnosis of SSS, and the infrequently reported association of TA with SSS.