Pyloric index, a new parameter: predicting perioperative prognosis in neonates with hypertrophic pyloric stenosis.

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.