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Intravenous atropine treatment in infantile hypertrophic pyloric stenosis

Divisions of Paediatric Surgery and Radiology, Osaka Medical Centre and Research Institute for Maternal and Child Health, Osaka, Japan

Correspondence to:
Correspondence to:
Dr Kawahara, Division of Paediatric Surgery, Osaka Medical Centre and Research Institute for Maternal and Child Health, 840 Murodo-cho Izumi, Osaka, Japan 594-1101;
kawahara{at}pedsurg.med.osaka-u.ac.jp

Aims: To assess the efficacy of a new regimen of intravenous atropine treatment for infantile hypertrophic pyloric stenosis (IHPS) with special reference to regression of pyloric hypertrophy.

Methods: Atropine was given intravenously at a dose of 0.01 mg/kg six times a day before feeding in 19 patients with IHPS diagnosed from radiographic and ultrasonographic findings. When vomiting ceased and the infants were able to ingest 150 ml/kg/day formula after stepwise increases in feeding volume, they were given 0.02 mg/kg atropine six times a day orally and the dose was decreased stepwise.

Results: Of the 19 infants, 17 (89%) ceased projectile vomiting after treatment with intravenous (median seven days) and subsequent oral (median 44 days) atropine administration. The remaining two infants required surgery. No significant complications were encountered. Ultrasonography showed a significant (p < 0.05) decrease in pyloric muscle thickness, but no significant shortening of the pyloric canal after completion of the atropine treatment. The patients exhibited failure to thrive at presentation, but were thriving at 6 months of age (p < 0.01).

Conclusions: This atropine therapy resulted in satisfactory clinical recovery. Pyloric muscle thickness was significantly reduced.

Keywords: infantile hypertrophic pyloric stenosis; atropine; ultrasonography; vomiting

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Arch. Dis. Child. 2002 87: 1. [Extract] [Full Text] [PDF]

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				K. Muramori, A. Nagasaki, and T. Kawanami Ultrasonographic Serial Measurements of the Morphologic Resolution of the Pylorus After Ramstedt Pyloromyotomy for Infantile Hypertrophic Pyloric Stenosis J. Ultrasound Med., December 1, 2007; 26(12): 1681 - 1687. [Abstract] [Full Text] [PDF]

				D. Saur, J.-M. Vanderwinden, B. Seidler, R. M. Schmid, M.-H. De Laet, and H.-D. Allescher Single-nucleotide promoter polymorphism alters transcription of neuronal nitric oxide synthase exon 1c in infantile hypertrophic pyloric stenosis PNAS, February 10, 2004; 101(6): 1662 - 1667. [Abstract] [Full Text] [PDF]

				B Corner and H Kawahara Intravenous atropine treatment in infantile hypertrophic pyloric stenosis * Author's reply Arch. Dis. Child., January 1, 2003; 88(1): 87 - 87. [Full Text] [PDF]

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