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Updated: Jun 8, 2025
Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
Pyloric index, a new parameter: predicting perioperative prognosis in neonates with hypertrophic pyloric stenosis
Başak Kaya1, Hasan Akduman1, Dilek Dilli1
1Department of Neonatology, Dr. Sami Ulus Maternity and Child Research and Training Hospital, Altındag, Ankara, Turkey.
Insights
Ultrasonographic pyloric thickness and index measurements can predict clinical outcomes in infants with infantile hypertrophic pyloric stenosis (IHPS), aiding in timely diagnosis and treatment.
Area of Science:
- Pediatric Surgery
- Neonatal Medicine
- Diagnostic Imaging
Background:
- Infantile hypertrophic pyloric stenosis (IHPS) diagnosis delays can cause severe clinical and laboratory decompensation in infants.
- Early and accurate prognostic indicators are crucial for managing IHPS.
Purpose of the Study:
- To assess if pyloric dimensions via ultrasonography can predict IHPS clinical prognosis.
- To correlate pyloric measurements with infant clinical and laboratory parameters.
Main Methods:
- Retrospective observational study of 122 infants diagnosed with IHPS.
- Analysis of ultrasonographic pyloric dimensions (length, thickness, index) and preoperative laboratory values.
Main Results:
- Mean pyloric dimensions: length 20mm, thickness 5mm, index 96.5.
- Higher pyloric thickness (>5mm) and index (>100) correlated with hypokalemia, hypochloremia, and metabolic alkalosis.
Conclusions:
- Pyloric thickness and index are effective predictors of clinical prognosis in IHPS.
- These ultrasonographic parameters aid in perioperative management of IHPS.
Purpose:
Delays in the diagnosis and treatment of infantile hypertrophic pyloric stenosis (IHPS) may lead to laboratory and clinical decompensation in infants. The aim of this study was to determine whether pyloric measurement parameters can be effectively used in the clinical prognosis of IHPS by evaluating the relationship between pyloric dimensions on ultrasonographic evaluation at the time of presentation and clinical and laboratory parameters in infants with pyloric stenosis.
Methods:
A retrospective observational study was conducted on 122 infants who were followed up with the diagnosis of IHPS in our neonatal clinic and operated on by a pediatric surgeon between January 2005 and December 2020.
Results:
The mean pyloric dimensions of the infants were pyloric length 20 mm (17-22), pyloric thickness 5 mm (4-5.8), and pyloric index 96.5 (72.2-124). Babies with preoperative laboratory values of hypokalemia, hypochloremia and metabolic alkalosis had statistically higher pyloric thickness >5 mm (4.1-6) and pyloric index >100 (86-130) parameters.
Conclusion:
Pyloric thickness and pyloric index parameters can predict clinical prognosis in babies diagnosed with IHPS in the perioperative period.
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