All issues > Volume 43(6); 2000

Original Article

J Korean Pediatr Soc. 2000;43(6):763-768. Published online June 15, 2000.

Infantile Hypertrophic Pyloric Stenosis Treated with Intravenous Atropine Sulfate

Jae Woo JW Lim¹, Hee Sook HS Son¹, Kye Shik KS Shim¹, Kyu Chul KC Choeh¹, Tae Il TI Han²

¹Department of Pediatrics, Eulji Medical College, Taejon, Korea
²Department of Radiology, Eulji Medical College, Taejon, Korea

Abstract

Purpose
: The pharmacologic effect of atropine on HPS can be considered to control pyloric muscle spasm. Therefore, we studied the effects of intravenous atropine sulfate on the clinical course of HPS, and periodically observed the ultrasonographic appearance of the pyloric muscles after atropine treatment.
Methods
: From April 1998 to May 1999, 14 infants who were diagnosed with HPS were treated with intravenous atropine sulfate. Intravenous atropine sulfate was administered at an initial dose of 0.04mg/kg/day, which was divided into 8 equal doses. The daily dose was increased by 0.01 mg/kg/day until vomiting was controlled for an entire day while infants received unrestricted oral feeding. Ultrasonographic examinations were performed during hospitalization and repeated at least every 2 months until normalization of pyloric muscles was confirmed.
Results
: Intravenous atropine was effective in 12 of 14 infants with HPS and the conditions of 9 of them improved. Two infants who were not free from vomiting despite a week of intravenous atropine sulfate treatment underwent pyloromyotomy. A series of ultrasonographic examinations were done after vomiting had improved with intravenous atropine sulfate. The ultrasonographic findings showed good passage of gastric contents through pyloric canals despite thickening of the pyloric muscles.
Conclusion
: Intravenous administration of atropine sulfate is an effective therapy for HPS and can be an alternative to pyloromyotomy.

Keywords :Atropine sulfate, Intravenous, Hypertrophic pyloric stenosis