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. 2002 Jul;87(1):71–74. doi: 10.1136/adc.87.1.71

Intravenous atropine treatment in infantile hypertrophic pyloric stenosis

H Kawahara 1, K Imura 1, M Nishikawa 1, M Yagi 1, A Kubota 1
PMCID: PMC1751140  PMID: 12089130

Abstract

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.

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Figure 1 .

Figure 1

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Serial changes in weight standard deviation scores (SDS) in patients successfully treated with atropine. Box, interquartile range; horizontal bar, median; whiskers, 10th and 90th centile. *p < 0.01, **p < 0.05.

Figure 2 .

Figure 2

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Serial changes in pyloric muscle thickness (A) and pyloric canal length (B) of patients successfully treated with atropine. Box, interquartile range; horizontal bar, median; whiskers, 10th and 90th centile. *p < 0.01, **p < 0.05.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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