Intravenous atropine treatment in infantile hypertrophic pyloric stenosis.
OBJECTIVE
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.
Kawahara
H
H
Division of Paediatric Surgery, Osaka Medical Centre and Research Institute for Maternal and Child Health, Osaka, Japan. kawahara@pedsurg.med.osaka-u.ac.jp
Imura
K
K
Nishikawa
M
M
Yagi
M
M
Kubota
A
A
D001285:Atropine / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000000981:diagnostic imaging / Q000188:drug therapy; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D018727:Muscarinic Antagonists / Q000008:administration & dosage*; D011707:Pyloric Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011708:Pylorus / Q000473:pathology*; D014463:Ultrasonography; D014839:Vomiting / Q000517:prevention & control
D018727:Muscarinic Antagonists; D001285:Atropine