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A diagnosis obscured: pyloric stenosis with situs inversus
  1. BRENDAN HARRINGTON
  1. Department of Child Health
  2. St Mary’s Hospital
  3. Hathersage Road, Manchester M13 0JH
  4. Departments of General Paediatrics* and Radiology **
  5. Royal Hospital for Sick Children
  6. St Michael’s Hill, Bristol BS2 0BJ
    1. TIMOTHY CHAMBERS

      *

      ,
    2. DAVID GRIER

      **

    1. Department of Child Health
    2. St Mary’s Hospital
    3. Hathersage Road, Manchester M13 0JH
    4. Departments of General Paediatrics* and Radiology **
    5. Royal Hospital for Sick Children
    6. St Michael’s Hill, Bristol BS2 0BJ

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      Editor,—The recent paper by Godbole et al is an interesting addition to the debate over the value of clinical examination versus ultrasound scanning in the diagnosis of infantile hypertrophic pyloric stenosis.1 Pyloric stenosis can often be diagnosed reliably on the basis of history and examination alone, with ultrasound imaging used only as an adjunct. In less certain cases, where history is strongly suggestive but examination is negative, ultrasound can be crucial. We describe a patient in whom an unusual incidental secondary diagnosis obscured the primary diagnosis and ultrasound confirmed both quickly and simply.

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