Intravenous atropine treatment in hypertrophic pyloric stenosis: evaluation by clinical course and imaging.
Hypertrophic pyloric stenosis (HPS) is the principal disease to consider in neonates presenting with frequent projectile vomiting and poor weight gain. Ramstedt pyloromyotomy is commonly used for the surgical treatment of HPS. The present study investigated the efficacy of nonsurgical medical treatment using intravenous administration of atropine and the examined the clinical course and results of ultrasonography and a contrast upper gastrointestinal series. A 34-day-old girl was admitted with chief complaints of projectile vomiting and poor weight gain. HPS was diagnosed on the basis of the clinical course and results of imaging studies. After intravenous administration of atropine, projectile vomiting resolved and weight increased without complications. On imaging studies, barium introduced into the stomach by tube rapidly entered the duodenum after atropine administration. Ultrasonography initially showed no reductions in hypertrophic muscle in the pyloric region, but gradual reductions were identified in subsequent months.
Asai
Makiko
M
Department of Pediatrics, Nippon Medical School Musashi Kosugi Hospital. maki-asa@nms.ac.jp
Katsube
Yasuhiro
Y
Takita
Yuuko
Y
Okada
Takuya
T
Hajikano
Miharu
M
Fujimatsu
Mariko
M
Kamisago
Mitsuhiro
M
Nishizawa
Yoshiki
Y
Fujita
Takehisa
T
D001285:Atropine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D018727:Muscarinic Antagonists / Q000008:administration & dosage*; D046248:Pyloric Stenosis, Hypertrophic / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011859:Radiography; D016896:Treatment Outcome; D014463:Ultrasonography
D018727:Muscarinic Antagonists; D001285:Atropine