Question 2 * Can a conservative approach to the treatment of hypertrophic pyloric stenosis with atropine be considered a real alternative to surgical pyloromyotomy?

Mercer, Anita Erika; Phillips, Bob

doi:10.1136/archdischild-2013-303655

Cited by 18 publications

(12 citation statements)

References 8 publications

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“…Initial IV atropine is more effective than oral atropine for treating IHPS despite the transient increase in serum ALT of 3.8e7.6%, which resolves without intervention. Mercer and Phillips 31 reported a success rate of 88% for conservative therapy with atropine in patients with IHPS. The result was gained from 10 studies pooled in a meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Medical Treatment for Infantile Hypertrophic Pyloric Stenosis: A Meta-analysis

Lin

Huang

et al. 2016

Pediatrics & Neonatology

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Section: Discussionmentioning

confidence: 99%

Efficacy of Medical Treatment for Infantile Hypertrophic Pyloric Stenosis: A Meta-analysis

Lin

Huang

et al. 2016

Pediatrics & Neonatology

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“…The most crucial disadvantage of IA therapy is the low success rate compared with that of conventional pyloromyotomy. 4,12 This retrospective case review was, therefore, designed to clarify risk factors for unsuccessful IA therapy. On multivariate analysis age < 30 days at diagnosis was the only predictive factor of a negative outcome of IA therapy.…”

Section: Discussionmentioning

confidence: 99%

“…The most crucial disadvantage of IA therapy is the low success rate compared with that of conventional pyloromyotomy . This retrospective case review was, therefore, designed to clarify risk factors for unsuccessful IA therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Pyloromyotomy has long been the standard therapy for infantile hypertrophic pyloric stenosis (IHPS), with a high success rate and low risk of associated complications, 1,2 but surgery and general anesthesia in very young children may have potential consequences, and expert pediatric surgeons may not be universally available. 3,4 Recently, atropine sulfate has been reappraised as a conservative treatment option, especially in Japan. [5][6][7][8] In the meta-analysis by Wu et al, 84% of patients receiving i.v.…”

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confidence: 99%

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Risk factors for unsuccessful atropine therapy in hypertrophic pyloric stenosis

Ono¹,

Takenouchi²,

Terui

et al. 2019

Pediatrics International

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Background I.v. atropine (IA) for infantile hypertrophic pyloric stenosis (IHPS) is a good alternative to pyloromyotomy but has not been broadly accepted. The lower success rate is one of the greatest disadvantages of IA. We investigated the risk factors for unsuccessful results following IA for IHPS. Methods Medical records of patients with IHPS who were admitted to Kimitsu Chuo Hospital between 2002 and 2016 and were initially given atropine sulfate were retrospectively reviewed. Atropine was given i.v. (0.1 mg/kg/day in eight divided doses). Oral feeding of milk was started with a small amount and increased in a stepwise fashion to full feed. IA therapy was defined as unsuccessful in the presence of projectile vomiting more than three times a day or intolerance to a predetermined amount of milk. Results Of the 48 patients with IHPS, 33 patients were successfully treated with IA and 15 patients needed surgical intervention. On univariate analysis the risk factors for unsuccessful IA therapy were younger age, lower bodyweight, and shorter duration of symptoms before diagnosis. On multivariate analysis age at diagnosis < 30 days was the only significant risk factor for unsuccessful IA therapy (OR, 5.7 l P = 0.03). Conclusions Age at diagnosis < 30 days is a risk factor for unsuccessful IA therapy in IHPS. This might be considered when IA therapy is used for neonates with IHPS.

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“…Conservative management includes oral or intravenous atropine sulphate and has been described in the literature. [6][7][8][9][10][11] Regenbaum et al reported the first case of IHPS in a premature infant with TNMG. 12 The occurrence of TNMG with IHPS was explained on the use of anticholinesterase therapy, which may potentiate a vagal response, leading secondarily to smooth muscle pyloric hypertrophy.…”

Section: Discussionmentioning

confidence: 99%

Transient neonatal myasthenia gravis with infantile hypertrophic pyloric stenosis: coincidence or causation?

Pandita¹,

Sharma

Murki

et al. 2017

Trop Doct

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Question 2 * Can a conservative approach to the treatment of hypertrophic pyloric stenosis with atropine be considered a real alternative to surgical pyloromyotomy?

Cited by 18 publications

References 8 publications

Efficacy of Medical Treatment for Infantile Hypertrophic Pyloric Stenosis: A Meta-analysis

Efficacy of Medical Treatment for Infantile Hypertrophic Pyloric Stenosis: A Meta-analysis

Risk factors for unsuccessful atropine therapy in hypertrophic pyloric stenosis

Transient neonatal myasthenia gravis with infantile hypertrophic pyloric stenosis: coincidence or causation?

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