Hypertrophic pyloric stenosis in premature infants: evaluation of sonographic criteria and short-term outcomes

Cascio, Salvatore; Steven, Mairi; Livingstone, H. M.; Young, David; Carachi, Robert

doi:10.1007/s00383-013-3324-6

Cited by 18 publications

(18 citation statements)

References 17 publications

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“…In our study, mean PR was close to these values in infants with IHPS. Also, both age and weight were not significantly correlated with PR, which was similar to the results of the above mentioned studies [7,8].…”

Section: Discussionsupporting

confidence: 89%

“…Iqbal et al [14] reported that age had a positive correlation with PMT which is consistent with our results; however, unlike us they found that weight had a positive correlation with PMT and age positively correlated with PL. In their study including premature infants, Cascio et al [8] found that PMT and PL were not affected by weight and corrected gestational age. Forster et al [11] also found no significant correlation between age, weight or prematurity and sonographical diagnosis of IHPS, regarding PMT and PL.…”

Section: Discussionmentioning

confidence: 92%

“…We consider that the differences between the results of above mentioned studies including our study, can be explained by the differences in the study designs (inclusion of infants with relatively homogenious vs heterogenious age spectrum), by diversities in the number of cases in different studies and by US factors. In some studies only relatively younger infants were included [8,9] whereas in others, infants with a relatively wide age spectrum were evaluated [10,11]. Relatively a small number of patients in some groups might have caused a decrease in statistical power and the inclusion of a relatively high number of patients with extreme age and weight values with different duration of symptoms in some groups, might have caused the differences in the results.…”

Section: Discussionmentioning

confidence: 99%

“…Lowe et al [7] reported the average PR in normal children (n=50) and in those with IHPS (n=34) as 0.205 and 0.325, respectively (p<0.001). Cascio et al [8] calculated PR in 15 premature infants and the median was 0.38. In our study, mean PR was close to these values in infants with IHPS.…”

Section: Discussionmentioning

confidence: 99%

“…Only in a few studies was the pyloric ratio (PR) evaluated and it was found to be an additional and useful US parameter in the diagnosis of IHPS in infants with different age and weights [7], including premature infants [8]. Despite the controversial relationship of age and weight with basic pyloric size measurements which is still a subject of debate today [8][9][10][11], PR seems to be a more stable parameter because it does not vary with age and weight [7,8].…”

Section: Introductionmentioning

confidence: 99%

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The use of ultrasonography in infantile hypertrophic pyloric stenosis: do the patientâ€™s age and weight affect pyloric size and pyloric ratio?

et al. 2015

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Aims: We aimed to obtain pyloric measurements of our patients with infantile hypertrophic pyloric stenosis (IHPS) using ultrasonography (US) and to evaluate the correlations between age, weight and pyloric size, pyloric ratio (PR). Material and methods: We designed a retrospective study including 20 term infants with surgically proven IHPS and studied the ultrasonographically obtained pyloric muscle thickness (PMT), pyloric diameter (width) (PD), pyloric length (PL) and PR (PMT/PD) to determine if there were statistically significant associations between patient age/weight and pyloric measurements. Results: The mean age of the infants was 38.7±17.3 days (range, 9-76 days) and their mean weight was 3688.5±772.7 g (range, 2810-6000 g), at referral. Mean PMT was 4.98±1.04 mm (range, 3.5-6.8 mm). Mean PD was 14.04±2.39 mm (range, 10-18 mm). Mean PL was 22.16±4.02 mm (range, 16-31.5 mm) and mean PR was 0.35±0.04 (range, 0.29-0.42). The correlation between age and PMT (r=0.654, p<0.05) and the correlation between age and PD (r=0.747, p <0.05) were significant. Age and weight were not significantly correlated with PR (p>0.05). Conclusions: The PMT and PD are age dependent parameters. The PR is age and weight independent and therefore, when combined with PMT, PD and PL, it can be useful in the diagnosis of IHPS in infants with early onset disease and/or in those with a lower weight.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The use of ultrasonography in infantile hypertrophic pyloric stenosis: do the patientâ€™s age and weight affect pyloric size and pyloric ratio?

et al. 2015

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Ultrasound diagnosis of hypertrophic pyloric stenosis – Time to change the criteria

Piotto

Gent

Taranath

et al. 2022

Australas J Ultrason Med

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Introduction Ultrasound is the examination of choice for the diagnosis of hypertrophic pyloric stenosis (HPS). A correct diagnosis is dependent on the technique and measurement accuracy. However, in the world literature there is a wide range of values suggested for the diagnosis of this condition. The current minimum measurements used to diagnose HPS seem excessively large, and therefore, we set out to redefine these values. Methods A retrospective study was performed on 607 patients (615 scans) being investigated for HPS. The length and transverse diameter of the pyloric canal, and thickness of the pyloric muscle were measured. All results were correlated with clinical and surgical findings. Results In this study, the muscle thickness in the normal group was <2.0 mm than in HPS infants having a muscle thickness of 2.0–5.0 mm. All the pyloric canal lengths in the normal group were <5.0 mm than in those with HPS having a length of 10.0–24.0 mm. The transverse diameters ranged from 6.0 to 11.0 mm in the normal group compared with those with HPS having a diameter between 8.0 and 16.0 mm. Conclusions The current criteria for sonographic diagnosis of HPS should be redefined. The canal length is the single most important discriminator, with a clear separation between normal and abnormal. The commonly used 16.0‐mm measurement is too long and should be reduced to 10.0 mm (without the risk of false positives). In many cases, the muscle thickness in those with HPS is as low as 2.0 mm, considerably less than the 3.0 mm that is currently used. The transverse diameter is not a useful discriminator for HPS. The use of current values will delay the diagnosis and timely treatment of this condition.

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The Gastrointestinal Tract

Munden

Paltiel

2021

Pediatric Ultrasound

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Hypertrophic pyloric stenosis in premature infants: evaluation of sonographic criteria and short-term outcomes

Cited by 18 publications

References 17 publications

The use of ultrasonography in infantile hypertrophic pyloric stenosis: do the patientâ€™s age and weight affect pyloric size and pyloric ratio?

The use of ultrasonography in infantile hypertrophic pyloric stenosis: do the patientâ€™s age and weight affect pyloric size and pyloric ratio?

Ultrasound diagnosis of hypertrophic pyloric stenosis – Time to change the criteria

The Gastrointestinal Tract

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