Pyloric Tit sign in the stomach on barium studies: What causes it?
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Pyloric Tit sign is caused by hypertrophic pyloric stenosis, a condition characterized by idiopathic thickening and hypertrophy of the pyloric muscle in infants leading to gastric outlet obstruction. This sign represents the transient trapping of contrast medium between a peristaltic wave and the thickened, hypertrophied pyloric muscle adjacent to the lesser curvature of the stomach on barium studies.
Why is it called so?
It is called the “Tit sign” because the focused outpouching or projection of contrast medium along the lesser curvature of the stomach resembles the shape of a nipple or “tit,” created by the localized distortion from the hypertrophied pyloric muscle.
Pathophysiology
The hypertrophied circular muscle of the pylorus causes narrowing of the pyloric canal and disrupts normal peristaltic flow. When contrast passes through the stomach during an barium study, it becomes transiently trapped between the advancing peristaltic wave and the firm, thickened pyloric muscle. This creates a characteristic outpouching or nipple-like projection seen on fluoroscopic images along the lesser curvature of the antrum, corresponding to the hypertrophied pylorus.
Alternative names: None widely used specifically for this sign.
Other associated named signs: Shoulder sign (indentation of the contrast-filled antrum by hypertrophied pylorus), Mushroom sign (indentation at the base of the duodenal bulb), Twining recess or Diamond sign (tentlike cleft in the pyloric canal).
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