Assessment of Changes in the Morphometric Measurements of the Abdomen in Children with Age

A BSTRACT Introduction: Significant changes occur in the shape and size of the abdomen with age. We aimed to correlate the morphometric measurements of the abdominal wall with age and establish a nomogram to demonstrate that the shape of the abdomen changes as a child grows, highlighting the need to choose different abdominal skin incisions as per age in children. Materials and Methods: A single-center prospective observational study was carried out from July 2023 to December 2024. All consecutive patients in the age groups of term newborns to 18 years visiting the department of Pediatric Surgery of a tertiary teaching hospital were enrolled in our study. The demographic and abdominal parameters were recorded. Results: Four hundred patients were included in the study. The mean age was 5.05 ± 4.3 years. There were 286 (71.5%) males and 114 (28.5%) females. The mean values of xipho-pubic AB (vertical diameter), EF (transverse diameter), costo-iliac, and EF/AB (transverse diameter/vertical diameter) were 19.83 ± 4.72 cm, 15.98 ± 2.32 cm, 9.02 ± 1.89 cm, and 0.83 ± 0.14, respectively. 92.25% ( n = 369) of cases qualified for vertical skin incision, while only 7.75% ( n = 31) qualified for transverse skin incision. Interpretation of the area under the receiver operating characteristic curve showed that the performance of age fell into the “outstanding” category. Based on this, it can be asserted that 0.92 years is the age at which EF/AB is <1, with a sensitivity of 88.1% and specificity of 83.9%. Conclusion: The cutoff age between transverse and vertical abdominal skin incisions was determined to be 11 months. The vertical skin incision was the preferred option for all age groups. A transverse skin incision may be considered in children under 11 months of age.