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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

More, Edit...

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

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Finding SensitivitySpecificity Comments, Study
Abdominal Mass Edit 73%100%

pyloric stenosis vs GERD

Most pediatricians find that feeling pyloric mass is very insensitive.

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

Abdominal US Edit 90%100%

Study: J Pediatr Surg. 1998 May;33(5):676-81. PMID: 9607467

Abnormal Serum Bicarbonate Edit 36%99%

>= 29 mmol/l

pyloric stenosis vs GERD

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

Abnormal Serum Chloride Edit 50%99%

<= 98 mmol/l

pyloric stenosis vs GERD

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

Projectile Vomiting Edit 93%39%

pyloric stenosis vs GERD

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

Upper GI Series Edit 100%100%

The decision analysis concluded that UGI should be the first test ordered, rather than US.

Study: J Pediatr Surg. 1998 May;33(5):676-81. PMID: 9607467

Weight loss Edit 81%68%

pyloric stenosis vs GERD

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