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Intravenous atropine treatment in infantile hypertrophic pyloric stenosis

H Kawahara1, K Imura, M Nishikawa

  • 1Division of Paediatric Surgery, Osaka Medical Centre and Research Institute for Maternal and Child Health, Osaka, Japan. kawahara@pedsurg.med.osaka-u.ac.jp

Archives of Disease in Childhood
|June 29, 2002
PubMed

Insights

Intravenous atropine effectively treats infantile hypertrophic pyloric stenosis (IHPS), significantly reducing pyloric muscle thickness and resolving projectile vomiting in most infants. This new regimen offers a promising, non-surgical therapeutic option.

Area of Science:

  • Pediatric Gastroenterology
  • Neonatal Surgery

Background:

  • Infantile hypertrophic pyloric stenosis (IHPS) is a common neonatal surgical condition.
  • Pyloric hypertrophy necessitates surgical intervention in many cases.

Purpose of the Study:

  • To evaluate the efficacy of a novel intravenous atropine treatment regimen for IHPS.
  • To specifically assess the impact of atropine on pyloric hypertrophy regression.

Main Methods:

  • Nineteen infants diagnosed with IHPS received intravenous atropine (0.01 mg/kg, 6x/day).
  • Successful treatment involved transition to oral atropine (0.02 mg/kg, 6x/day) with gradual dose reduction.
  • Diagnosis was confirmed via radiographic and ultrasonographic imaging.

Main Results:

  • 89% of infants (17/19) ceased projectile vomiting with atropine therapy (IV median 7 days, oral median 44 days).
  • Ultrasonography revealed a significant decrease in pyloric muscle thickness (p < 0.05).
  • Infants showed improved thriving status at 6 months (p < 0.01).

Conclusions:

  • Intravenous atropine therapy provides satisfactory clinical recovery for IHPS.
  • The treatment leads to significant reduction in pyloric muscle thickness, offering a non-surgical approach.
Abstract

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