Evaluation of ultrasonographic parameters in the diagnosis of pyloric stenosis relative to patient age and size.
BACKGROUND
Pyloric thickness of 3 mm or higher and length of 15 mm or higher by ultrasonography (US) is widely accepted as diagnostic criteria for pyloric stenosis (PS). However, infants presenting at earlier ages are held to this same criteria, which may not be applicable.


METHODS
Retrospective review was conducted on patients evaluated with pyloric US to rule out PS from May 2010 through December 2010. Pearson correlation was used to detect an association between weight and age with pyloric thickness and length. Sensitivity and specificity for US parameters were determined.


RESULTS
Three hundred four patients underwent 318 ultrasounds, of which 67 had PS. Of those with PS, age and weight had a positive correlation with thickness (P < .007), and age positively correlated with length (P < .001). In patients with and without PS, there was a negative correlation for both age and weight with thickness (P < .02). Those who did not have PS held a stronger negative correlation between age and thickness (P = .002). Overall, US had a 100% sensitivity and specificity for PS. Thickness of 3 mm or higher was 100% sensitive and 99% specific, and pyloric length of 15 mm or higher was 100% sensitive and 97% specific.


CONCLUSIONS
Although significant associations between age and weight with pyloric thickness and length may exist, our data indicate that this does not have an impact on the diagnostic criteria for PS.
Children's Mercy Hospital Department of Surgery, The Children's Mercy Hospital, Kansas City, MO, USA. ciqbal@cmh.edu
Corey W
CW
Iqbal
Douglas C
DC
Rivard
Vincent E
VE
Mortellaro
Susan W
SW
Sharp
Shawn D
SD
St Peter
D000367:Age Factors; D000886:Anthropometry; D049628:Body Size; D001835:Body Weight; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009130:Muscle, Smooth / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D009929:Organ Size; D011237:Predictive Value of Tests; D046248:Pyloric Stenosis, Hypertrophic / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011708:Pylorus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography