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Atropine Treatment for Hypertrophic Pyloric Stenosis: A Systematic Review and Meta-Analysis

Giuseppe Lauriti1,2, Valentina Cascini1, Pierluigi Lelli Chiesa1

  • 1Department of Pediatric Surgery, "Spirito Santo" Hospital and "G. d'Annunzio" University, Chieti-Pescara, Italy.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|July 13, 2017
PubMed

Insights

Atropine is less effective than pyloromyotomy for treating infantile hypertrophic pyloric stenosis (HPS). Current evidence does not support atropine therapy for HPS, reserving it for specific surgical candidates.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Pharmacology

Background:

  • Hypertrophic pyloric stenosis (HPS) is a common infant condition.
  • Atropine has been proposed as a non-surgical alternative to pyloromyotomy for HPS.
  • Evidence on atropine's efficacy and safety in HPS treatment is limited.

Purpose of the Study:

  • To review the efficacy of atropine in treating HPS.
  • To compare atropine therapy with surgical pyloromyotomy.

Main Methods:

  • Systematic review and meta-analysis of published studies.
  • Searched PubMed, MEDLINE, OVID, Embase, and Cochrane databases.
  • Excluded case reports and opinion articles; analyzed 51 full-text articles (508 infants).

Main Results:

  • Atropine successfully treated HPS in 79.1% of infants (402/508).
  • Reported atropine side effects in 15.1% of infants included tachycardia and flushed skin.
  • Meta-analysis showed pyloromyotomy had a higher success rate (100% vs. 80.8%) and shorter hospital stay (5.6 vs. 10.3 days) compared to atropine.

Conclusions:

  • Comparative studies suggest atropine is less effective than pyloromyotomy for HPS.
  • There is a lack of high-quality evidence supporting atropine for HPS.
  • Atropine should be reserved for infants unsuitable for anesthesia or surgery.
Abstract

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