Treating idiopathic hypertrophic pyloric stenosis with sequential therapy: A clinical study

Fan, Jianfeng; Shi, Yingzuo; Cheng, Mei‐Fang; Zhu, Xiaomin; Wang, Dafeng

doi:10.1111/jpc.13184

Cited by 6 publications

(12 citation statements)

References 16 publications

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“…Un ejemplo de ello son las lesiones proliferativas, que son de carácter benigno y representan uno de los principales diagnósticos diferenciales del melanoma, pues comparten algunas características como el rápido crecimiento, el cambio en el color o la forma y la ulceración. En la histología, ambos presentan una alta tasa mitótica, con mitosis atípicas, atipia nuclear y necrosis; sin embargo, una cuenta mitótica > 5 mitosis/mm 2 y un cambio parcial en el número de copias de los cromosomas, determinado por hibridación fluorescente in situ (FISH, por sus siglas en inglés fluorescence in situ hybridization), aumenta la posibilidad diagnóstica de melanoma [28][29][30] .…”

Section: Complicacionesunclassified

Nevo melanocítico congénito gigante

Escandón-Pérez¹,

Landeta-Sa²,

González-Jasso³

et al. 2019

BMHIM

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Los nevos melanocíticos congénitos gigantes (NMCG) son lesiones melanocíticas secundarias a la migración anormal de los melanoblastos durante la embriogénesis. Afectan aproximadamente a 1 de cada 20,000 nacidos vivos y suelen estar presentes desde el nacimiento. Estas lesiones se distinguen porque cambian sus características morfológicas con el tiempo y aumentan su tamaño de forma paralela al crecimiento del niño, alcanzando un diámetro ≥ 20 cm en la edad adulta. La importancia de los NMCG radica en las complicaciones a las que se encuentran asociados, principalmente al desarrollo de melanoma o melanosis neurocutánea, además del impacto psicológico y social que generan en la mayoría de los casos, por lo que quienes los padecen requerirán de un seguimiento multidisciplinario a largo plazo. Actualmente, el manejo de los niños con NMCG continúa siendo controversial, ya que no existe un tratamiento de elección, por lo que este deberá ser individualizado de acuerdo con las características del nevo y las necesidades específicas de cada paciente.

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Section: Complicacionesunclassified

Nevo melanocítico congénito gigante

Escandón-Pérez¹,

Landeta-Sa²,

González-Jasso³

et al. 2019

BMHIM

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“…Although Haas himself did report success in treating advanced ‘pylorospasm’ and true stenosis, he also conceded that surgical intervention was occasionally justified. Although surgery has become the standard of care today, in some settings, medical treatment with atropine continues to be employed with acceptable results …”

Section: A Pylorus In Systole: Origins Of Medical Approachesmentioning

confidence: 99%

The treatment of pyloric stenosis: Evolution in practice

Taghavi

Powell

Patel

et al. 2017

J Paediatrics Child Health

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Over the last hundred years, idiopathic hypertrophic pyloric stenosis has undergone an evolution in treatment, with subsequent improvements in outcome. Initially, it was treated by physicians with antispasmodics and various alternative feeding and resuscitation modalities. The evolution of surgical approaches led to a revolution in outcome, from almost certain death to complete cure. The progression of surgical and medical treatments is reviewed in this article until, ultimately, Ramstedt's pyloromyotomy is reached. This distilled operation has remained the gold-standard procedure for over a century.

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“…The influence of the pyloric muscle thickness is of no statistical significance on the outcome of atropine treatment. 32 There are only a few articles that mention other options of non-operative treatment such as spasmolytic treatment dating from 1950-1986, balloon catheter dilatation of pyloric stenosis dating from 1990 and tetrahydrobiopterin for restoration of nitric oxide synthase activity in pyloric muscle, dating from 1997. [33][34][35] Although these few options have been adopted by some researches, their significance is minor and marginal, with no use in clinical practice.…”

mentioning

confidence: 99%

Database analysis of oral atropine treatment of infantile hypertrophic pyloric stenosis. A ten-year single center experience

et al. 2021

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Introduction/Aim. Infantile hypertrophic pyloric stenosis (IHPS) is the most common cause of surgery in the newborn and young infant. Conservative treatment of IHPS is of a great importance because it saves a newborn from stress caused by surgery and general anesthesia. This study evaluates the impact of various oral administration regimens of atropine on its efficacy in treating IHPS. Methods. The study included 45 patients with IHPS, conservatively treated by atropine sulfate in the period from 2006-2016. Clinical examination, laboratory analysis and ultrasonography were performed for all patients on admission. We analyzed the efficacy of treatment, with different oral dosage regimens and definition of potential predictive factors of the negative outcome. Evaluation was statistically analyzed by the method of multivariate logistic regression model. Results. Group of patients, conservatively treated, included 45 patients, of whom 36 (80%, p=0,0008) were successfully cured, without need for surgery and without complications. It has been shown that in terms of sex prevalence, age, birth weight, body weight on admission, duration of symptoms, pyloric muscle thickness and length, there is no statistically significant individual effect on the success of atropine treatment. Patients who received progressively increased dose of atropine have an 18 times higher risk of surgery, patients who have hypochloremic alkalosis (HCA) have a 15 times higher risk, while others, who have more than 5 vomiting within the first three days of therapy are 9 times more likely to be surgically treated. Conclusion. High success rate and no side effects represent an orally administered atropine treatment as a valid alternative indication for non-operative management of IHPS. Administration of initially high doses has been shown to be more effective in relation to gradually increased oral doses of atropine sulfate. HCA and continued vomiting are considered as potential predictive factors of negative outcome of atropine treatment.

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Treating idiopathic hypertrophic pyloric stenosis with sequential therapy: A clinical study

Abstract: Atropine ST is safe, effective and cost-effective as compared with operation; however, the efficacy of ST is lower than operation.

Cited by 6 publications

References 16 publications

Nevo melanocítico congénito gigante

Nevo melanocítico congénito gigante

The treatment of pyloric stenosis: Evolution in practice

Database analysis of oral atropine treatment of infantile hypertrophic pyloric stenosis. A ten-year single center experience

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