title: Evaluation of hypertrophic pyloric stenosis by pediatric emergency physician sonography.
abstract: OBJECTIVE
  The objective was to evaluate the accuracy of pediatric emergency physician (EP) sonography for infants with suspected hypertrophic pyloric stenosis (HPS).
  
  
  METHODS
  This was a prospective observational pilot study in an urban academic pediatric emergency department (PED). Patients were selected if the treating physician ordered an ultrasound (US) in the department of radiology for the evaluation of suspected HPS.
  
  
  RESULTS
  Sixty-seven patients were enrolled from August 2009 through April 2012. When identifying the pylorus, pediatric EPs correctly identified all 10 positive cases, with a sensitivity of 100% (95% confidence interval [CI] = 62% to 100%) and specificity of 100% (95% CI = 92% to 100%). There was no statistical difference between the measurements obtained by pediatric EPs and radiology staff for pyloric muscle width or length (p = 0.5 and p = 0.79, respectively).
  
  
  CONCLUSIONS
  Trained pediatric EPs can accurately assess the pylorus with US in the evaluation of HPS with good specificity.
authors.affiliation: Department of Emergency Medicine, Newark Beth Israel Medical Center, Children's Hospital of New Jersey, Newark, NJ, USA. asivitz@gmail.com
authors.forename: Adam B
authors.initials: AB
authors.lastname: Sivitz
authors.forename: Cena
authors.initials: C
authors.lastname: Tejani
authors.forename: Stephanie G
authors.initials: SG
authors.lastname: Cohen
mesh_terms: D000046:Academic Medical Centers; D002675:Child, Preschool; D016001:Confidence Intervals; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D046248:Pyloric Stenosis, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011786:Quality Control; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler