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Pyloric Stenosis: Sensitivity and Specificity

Introduction: Congenital hypertrophy of the pyloris, i.e. the gastric outlet. Onset on average 3-5 weeks of life. Corrected surgically.

Note that the diagnostic accuracies have changed over time:

" Over the 25-year period, 901 infants underwent PM. Patients presented at a younger age, weighed more, and had a shorter length of illness in the most recent time period. Hypochloremic alkalosis was found half as frequently in the most recent time period compared to the earliest group. A palpable pyloric tumor was present in 79% of patients in the earliest time period compared with 23% in the most recent time period. Sixty-one percent of patients in the earliest group and 96% in the latest group underwent an imaging study, reflecting the referring physician's evaluation before referral to the surgeon." [PMID 9233980]

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Tags: Congenital Gastrointestinal Problem Tag this Diagnosis.

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Infants 0.3% Boys 5x more likely than girls.

Am J Emerg Med. 1999 Jan;17(1):28-31. PMID: 9928693

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The sensitivity and specificity of findings for Pyloric Stenosis are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %. Post-Test Probability (Predictive Value): %. Switch to display mode.
**Note that calculating probabilities from more than one finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)
FindingResult SensitivitySpecificity
[ + ] Abdominal Mass + 0 - 73%100%
[ + ] Abdominal US + 0 - 90%100%
[ + ] Abnormal Serum Bicarbonate + 0 - 36%99%
[ + ] Abnormal Serum Chloride + 0 - 50%99%
[ + ] Projectile Vomiting + 0 - 93%39%
[ + ] Upper GI Series + 0 - 100%100%
[ + ] Weight loss + 0 - 81%68%