Pyloromyotomy versus atropine sulfate for infantile hypertrophic pyloric stenosis

Conservative treatment of infantile hypertrophic pyloric stenosis with intravenous atropine sulfate does not replace pyloromyotomy

“…A number of other open trials, primarily from Japan, have demonstrated a similar effectiveness of i.v. atropine sulfate with success rates between 86 and 96% [18][19][20].…”

Medical treatment of infantile hypertrophic pyloric stenosis: should we always slice the “olive”?

“…Medical treatment with atropine has been reappraised as an option for IHPS treatment using a step-up dosage technique with intravenous atropine administration and is associated with a successful short-term outcome [4,6]. On the other hand, we devised our original regimen with a fixed dose of intravenous atropine and a gradual increase in oral intake to reduce the frequency of emesis [5].…”

“…However, recent studies regarding intravenous atropine therapy have shown significant success rates [4][5][6]. The current study assessed the efficacy and safety of our regimen of intravenous atropine therapy for IHPS in comparison with surgery.…”

Ultrasound follow-up of infantile hypertrophic pyloric stenosis (IHPS) during conservative therapy: ultrasound findings as criteria for diagnosis and cure

“…Measurement errors are common due to diffi culties that occur when examining restless infants and when manually measuring small distances that are frequently curvilinear, such as the pyloric canal length. Therefore, although various criteria for IHPS have been published, [3][4][5][6][7][8] we often hesitate to diagnose IHPS in infants in whom the pyloric wall thickness and the canal length are borderline. Even in infants who have been treated and clinically cured, there are many cases in which pyloric wall hypertrophy and pyloric canal elongation continue to be present, 1-4,9-12 since objective criteria for cure have not been established.…”

“…After these conditions have disappeared due to medication or surgical treatment, even if pyloric wall thickening and pyloric canal elongation continue to be present, the echogenicity of the pyloric wall becomes homogeneous and hypoechoic, wall stratifi cation appears in the pylorus, and the patients are clinically cured. 2,4,9 Vomiting does not recur once wall stratifi cation has appeared during the cured stage.…”