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Evaluation of Hypertrophic Pyloric Stenosis by Pediatric Emergency Physician Sonography
Author(s) -
Sivitz Adam B.,
Tejani Cena,
Cohen Stephanie G.
Publication year - 2013
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.12163
Subject(s) - medicine , hypertrophic pyloric stenosis , pylorus , emergency department , confidence interval , pyloric stenosis , prospective cohort study , stenosis , radiology , ultrasound , stomach , psychiatry
Objectives 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 EP s 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 EP s and radiology staff for pyloric muscle width or length (p = 0.5 and p = 0.79, respectively). Conclusions Trained pediatric EP s can accurately assess the pylorus with US in the evaluation of HPS with good specificity.