title: Surgeon-performed ultrasound for diagnosis of pyloric stenosis is accurate, reproducible, and clinically valuable.
abstract: OBJECTIVE
  We will demonstrate that a surgical resident with proven accuracy in the diagnosis of hypertrophic pyloric stenosis (HPS) can teach other surgeons to diagnose HPS with reproducible accuracy.
  
  
  METHODS
  A surgical resident with proven sonographic accuracy in diagnosing HPS instructed 5 other surgical residents in the technique. Consecutive patients referred to pediatric surgery with a presumed clinical diagnosis of HPS were examined, and measurements of residents were compared with formal radiology studies. Each surgeon was proctored for 5 examinations before independent evaluation and was blinded to results from both radiologists and other residents. Results were evaluated using Student's t test; P less than .05 was considered significant.
  
  
  RESULTS
  Seventy-one patients were evaluated by 5 surgical residents. Residents were diagnostically accurate in all cases. There was no statistically significant difference between pyloric muscle thickness or channel length measurements obtained by radiology and any of the residents.
  
  
  CONCLUSIONS
  Surgeon-performed ultrasound examination for the diagnosis of HPS is accurate and reproducible through surgeon-to-surgeon instruction on appropriate technique. This skill is a valuable asset in the initial surgical evaluation of any patient with suspected HPS, expediting appropriate management.
authors.affiliation: Arkansas Children's Hospital, Little Rock, 72202-3591, USA.
authors.forename: Marcene R
authors.initials: MR
authors.lastname: McVay
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Copeland
authors.forename: Lisa E
authors.initials: LE
authors.lastname: McMahon
authors.forename: Graham H
authors.initials: GH
authors.lastname: Cosper
authors.forename: Theresa G
authors.initials: TG
authors.lastname: McCallie
authors.forename: Evan R
authors.initials: ER
authors.lastname: Kokoska
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Jackson
authors.forename: Samuel D
authors.initials: SD
authors.lastname: Smith
mesh_terms: D002983:Clinical Competence; D006801:Humans; D007396:Internship and Residency; D011446:Prospective Studies; D046248:Pyloric Stenosis, Hypertrophic / Q000000981:diagnostic imaging* / Q000601:surgery; D015203:Reproducibility of Results; D014463:Ultrasonography