The diagnosis of pyloric stenosis is made on the history combined with plain abdominal X-ray. It may be possible to see a grossly dilated stomach filled with mottled shadowing caused by residual food.
Radiology is supplemented by endoscopy. It is necessary to clear the gastric residue using several washouts before endoscopy or a barium meal can be attempted. More than 500ml of gastric residue may be found on nasogastric intubation.
Note that it is important for the stomach to be cleared for surgery as well as these investigative procedures.
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