Indian Journal of Public Health Research & Development

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

A Study of the Effectiveness of Ultrasound in Diagnosing Infantile Pyloric Stenosis


Affiliations
1 Hassan Institute of Medical Sciences Hassan, Karnataka, India
     

   Subscribe/Renew Journal


Objectives: To evaluate the effectiveness of ultrasound for diagnosis and exclusion of pyloric Stenosis in the infants with nonbilious vomiting.

Methodology: In a cross-sectional study, 444 consecutive infants with clinical suspicion of pyloric Stenosis were evaluated by ultrasound (US) and categorized as pyloric Stenosis or not according measuring parameters as muscle thickness, muscle width and canal length of pylorus. Positive findings were confirmed at surgery; Negative findings were confirmed by means of follow up. Sensitivity, specificity and accuracy were calculated.

Results: Sensitivity, specificity and accuracy of ultrasound were 100% if pyloric muscle thickness of >3mm was chosen as diagnostic. When muscle thickness more than 4mm was used, sensitivity, specificity and accuracy were 96%, 100% and 99.32% respectively.

Conclusions: Ultrasound is highly sensitive and specific if pyloric muscle thickness 3 mm is used as cut off point. By virtue of direct visualization of the pyloric muscle, ultrasound is method of choice for both the diagnosis and exclusion of pyloric Stenosis in infants.


Keywords

Diagnosis, Infant, Pyloric Stenosis, Sensitivity and Specificity, Ultrasonography
Subscription Login to verify subscription
User
Notifications
Font Size


  • Sivit C, Siegel M. Gastrointestinal tract: Siegel M. Pediatric Sonography. 3rd ed. Philadelphia: Lippin cott Williams & Wilkins 2002; 340-343.

  • Wyllie R. Pyloric stenosis and congenital Anomalies of the stomach, Nelson Textbook of Pediatric, Beherman, Kliegman, Genson: Saunders, USA. 2004; 1229-1231.

  • Headback G, Abrahamssonk, Husberg B. The epidemiology of infantile Hypertrophic pyloric stenosis in Sweden 1987-96.Arch Dis Child 2001; 85(5): 379-381.

  • Hernanz –Schulman M. Infantile Hypertrophic Pyloric stenosis, Radiology 2003; 227: 319-331.

  • Finkelstein M, Mandell G, Trabell K, Hypertrophic Pyloric stenosis: Volumetric of Measurement of Nasogastric Aspirate to determine the imaging modality. Radiology 1997; 177: 759-767.

  • Teele RL, Smith EH. Ultrasound in the diagnosis of idiopathic hypertrophic pyloric stenosis. N Engl J Med 1997; 296: 1149-1150.

  • Hernanz-Schulman M, Sells LL, Ambrosino MM. Hypertrophic Pyloric Stenosis in the Infant without a Palpable Olive: Accuracy of Sonographic Diagnosis, Radiology 1994; 193: 771-776.

  • Okeefee FN, Stansberry SD, Swischuk LE. Antropyloric muscle thickness at ultrasound in infant: What is normal? Radiology 1991;178: 827-830.

  • Kirks DR, Buonomo C, Taylor GA, Share JC. Gastrointestinal Tract, practical pediatric imaging: Diagnostic Radiology of Infants and Children, 13th ed. Philadelphia: Lippin cott- Raven: 1998; 899-903.

  • Haller J, Cohen H. Hypertorophic Pyloric Stenosis: diagnosis using us. Radiology 1986; 161: 335-339.

  • Assefa G: Sonographic diagnosis of hypertrophic pyloric stenosis. Preliminary experience: Ethiop Med J 2002; 40: 149-54. stenosis. J Clin Ultrasound 1984; 12: 201-204.

  • Strauss S, Manor A, Graif M. Sonography of Hypertrophic pyloric stenosis. AJR 1981; 135: 1057-105.

  • Blumhagen JD, Coombs JB, Ultrasound in diagnosis of Hypertrophic pyloric stenosis. J Clin Ultrasound 1981; 9: 289-292.

  • Blumhagen JD, Noble HG. Muscle thickness in Hypertrophic pyloric stenosis: Sonographic determination. AJR 1983; 140: 221-223.

  • Macdessi J, Oates R. Clinical diagnosis of pyloric stenosis; a declining art. BMJ 1993; 306: 553-555.

  • Stevenson RJ. Non-neonatal intestinal obstruction in children. Surg Clin North Am 1985; 65: 1217-1234.


Abstract Views: 388

PDF Views: 0




  • A Study of the Effectiveness of Ultrasound in Diagnosing Infantile Pyloric Stenosis

Abstract Views: 388  |  PDF Views: 0

Authors

N. K. Srivatsa
Hassan Institute of Medical Sciences Hassan, Karnataka, India
S. K. Manuprakash
Hassan Institute of Medical Sciences Hassan, Karnataka, India

Abstract


Objectives: To evaluate the effectiveness of ultrasound for diagnosis and exclusion of pyloric Stenosis in the infants with nonbilious vomiting.

Methodology: In a cross-sectional study, 444 consecutive infants with clinical suspicion of pyloric Stenosis were evaluated by ultrasound (US) and categorized as pyloric Stenosis or not according measuring parameters as muscle thickness, muscle width and canal length of pylorus. Positive findings were confirmed at surgery; Negative findings were confirmed by means of follow up. Sensitivity, specificity and accuracy were calculated.

Results: Sensitivity, specificity and accuracy of ultrasound were 100% if pyloric muscle thickness of >3mm was chosen as diagnostic. When muscle thickness more than 4mm was used, sensitivity, specificity and accuracy were 96%, 100% and 99.32% respectively.

Conclusions: Ultrasound is highly sensitive and specific if pyloric muscle thickness 3 mm is used as cut off point. By virtue of direct visualization of the pyloric muscle, ultrasound is method of choice for both the diagnosis and exclusion of pyloric Stenosis in infants.


Keywords


Diagnosis, Infant, Pyloric Stenosis, Sensitivity and Specificity, Ultrasonography

References