Pyloric Size in Normal Infants and in Infants Suspected of Having Hypertrophic Pyloric Stenosis

Hallam, Dorte; Hansen, Bo Moelholm; Bødker, Birgit; Klintorp, Søren; Pedersen, Jan Fog

doi:10.1177/028418519503600309

Cited by 26 publications

(7 citation statements)

References 9 publications

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“…A ratio 0.27 or more is diagnostic for pyloric stenosis. Sensitivity and specificity of pyloric ratio is 96% and 94% respectively [20,21].…”

Section: Discussion:-mentioning

confidence: 98%

Demography and Ultrasound Measures in Infantile Hypertrophic Pyloric Stenosis - Our Institutional Experience

Kajala¹,

Barolia²,

Lal³

et al. 2020

IJAR

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Infantile hypertrophic pyloric stenosis (IHPS) is most common surgical cause of non-bilious vomiting in infants. This study describes the clinical presentation, diagnosis, management and outcome of management of infants with IHPS and identifies the factors responsible for poor outcome in these patients. Methods and Materials: This is a prospective study. It was conducted between September 2018 to April 2020 at J. K. Lone Hospital, SMS Medical College Jaipur, and Rajasthan, India. Results: A total 80 patients (M: F=4.7:1) were studied with male predominance. Mean age of presentation was 6.26 weeks. Maximum 47.5% (38) patients present in age group of >4-8 weeks. Clinical presentation with a triad of non-bilious projectile vomiting, visible gastric peristalsis and palpable Olive tumor was present in 62.5 % (50) patients. Non bilious vomiting was the most common presenting symptom, present in 100% (80) patients. Mean hospital stay was 4.23 days. Serum electrolytes disturbance was present in 61.5% (49) patients. The surgery was Ramstedt's pyloromyotomy done in all cases. Mortality rate was 3.75%.Thickness of pyloric muscles was increasing in proportional ratio with age. Conclusion: In this study delayed presentation and Serum electrolytes imbalance are most common causes of poor outcome. USG abdomen is best imaging modality for confirmation of diagnosis. Pyloric muscle wall thickness showed relation with age in proportional increasing pattern.

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“…A ratio 0.27 or more is diagnostic for pyloric stenosis. Sensitivity and specificity of pyloric ratio is 96% and 94% respectively [20,21].…”

Section: Discussion:-mentioning

confidence: 98%

Demography and Ultrasound Measures in Infantile Hypertrophic Pyloric Stenosis - Our Institutional Experience

Kajala¹,

Barolia²,

Lal³

et al. 2020

IJAR

View full text Add to dashboard Cite

show abstract

“…Measurement errors are common due to diffi culties that occur when examining restless infants and when manually measuring small distances that are frequently curvilinear, such as the pyloric canal length. Therefore, although various criteria for IHPS have been published, [3][4][5][6][7][8] we often hesitate to diagnose IHPS in infants in whom the pyloric wall thickness and the canal length are borderline. Even in infants who have been treated and clinically cured, there are many cases in which pyloric wall hypertrophy and pyloric canal elongation continue to be present, 1-4,9-12 since objective criteria for cure have not been established.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound follow-up of infantile hypertrophic pyloric stenosis (IHPS) during conservative therapy: ultrasound findings as criteria for diagnosis and cure

et al. 2008

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“…16 The diagnostic criteria of HPS were a pyloric muscle thickness (PMT) >3 mm, pyloric muscle length (PL) >15 mm, and/or pyloric diameter >10 mm on ultrasound. [17][18][19] All confirmative diagnoses of HPS were based on RADUS findings.…”

Section: Ultrasound Protocol and Group Designationmentioning

confidence: 99%

Feasibility of Point-of-Care Ultrasound for Diagnosing Hypertrophic Pyloric Stenosis in the Emergency Department

et al. 2021

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Objectives: This study aimed to investigate the feasibility of point-ofcare ultrasound (POCUS) for diagnosing hypertrophic pyloric stenosis (HPS) in the emergency department (ED).Methods: A retrospective study was conducted in infants aged younger than 90 days who were brought to the ED due to vomiting between January 2015 and December 2019. Of these, infants who were clinically suspected of having HPS and underwent ultrasound were included and categorized into 3 groups: POCUS only, POCUS followed by radiologist-performed ultrasound (RADUS), and RADUS only. All confirmative diagnoses of HPS were made by RADUS. The diagnostic performance of POCUS was analyzed, and the ED patient flow was compared between the POCUS-performed (POCUS only or POCUS followed by RADUS) and RADUS-only groups.Results: Overall, 171 patients with a median age of 34 days were included. Of these, 79 patients (46.2%) underwent POCUS only, and none had HPS; 50 patients (29.2%) underwent POCUS followed by RADUS; and 42 patients (24.5%) underwent RADUS only. Overall, 41 patients (24.0%) were diagnosed with HPS, and POCUS showed a sensitivity of 96.6% and specificity of 94.0%. In the total cohort, length of stay in the ED (EDLOS) was shorter in the POCUS-performed group than in the RADUS-only group (2.6 vs 3.8 hours, P = 0.015). Among non-HPS patients, time to disposition (1.8 vs 2.7 hours, P = 0.005) and EDLOS (2.0 vs 3.0 hours, P = 0.004) were shorter in the POCUS-performed group than in the RADUS-only group. Performing POCUS followed by RADUS did not significantly delay the treatment among HPS patients.Conclusions: Point-of-care ultrasound is accurate and useful for diagnosing HPS and improved the ED patient flow by reducing EDLOS and door-to-disposition time in non-HPS patients.

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Pyloric Size in Normal Infants and in Infants Suspected of Having Hypertrophic Pyloric Stenosis

Abstract: Pyloric muscle thickness (PMT) and pyloric diameter (PD) were determined by sonography in 92 healthy infants aged 8 to 70 days. PMT and PD measured median 2.0 mm and 10.0 mm. There was a significant correlation between the pyloric dimensions and the infant's age, p<0.02 and p Show more

Cited by 26 publications

References 9 publications

Demography and Ultrasound Measures in Infantile Hypertrophic Pyloric Stenosis - Our Institutional Experience

Demography and Ultrasound Measures in Infantile Hypertrophic Pyloric Stenosis - Our Institutional Experience

Ultrasound follow-up of infantile hypertrophic pyloric stenosis (IHPS) during conservative therapy: ultrasound findings as criteria for diagnosis and cure

Feasibility of Point-of-Care Ultrasound for Diagnosing Hypertrophic Pyloric Stenosis in the Emergency Department

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