Intravenous Atropine Sulfate Therapy for Infantile Hypertrophic Pyloric Stenosis

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Vol. 8, No.1. June 2002

Intravenous Atropine Sulfate Therapy for Infantile Hypertrophic Pyloric Stenosis

Seunho Bang, M.D., Yoon Jung Kang, M.D., Byoung Sun Joe, M.D., Tae Seok Lee, M.D.

Department of Surgery, Eulji University, College of Medicin Daejon, Korea

The purpose of this

study

is to evaluate the

applicability of

intravenous atropine sulfate therapy in infantile hypertrophic pyloric stenosis (IHPS) , From 1998 to 2000 among 35

cases of

IHPS, pyloromytomy was performed in 13

(Group

A),

and

intravenous atropine was given as

a

primary therapy in 22 cases (Group B). In group

A, all cases

were cured

completely.

In group B, 13 (59

%)

out of 22 cases were

successfully

treated with atropine, but

9

were failed therapy, and required operation, The recovery

period

to normal feeding and the hospital

stay

of the successful

atropine

group

were

longer than those

of pyloromyotomy, 8.6 days vs.

2.9 days and 13.2 days vs

.

4.1 days, respectively. In conclusion

,

intravenous atropine therapy did not replace pyloromyotomy, but it might be

an

alternative

for

the

selected

patients with contraindications for operation.

(J Kor Assoc Pediatr Surg 8(1):33-38), 2002.

Index Words: Infantile hypertrophic pyloric stenosis, Intrauenou') atropine sulfate therapy

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Correspondence: Tae Seok Lee, M.D. Department of Surgery, Eulji Medical Center, Eulji University, College of Medicine, 280-1, Hakae-1-dong, Nowon-gu, Seoul 139-231, Korea Tel: 02)970-8012, Fax: 02)970-8227

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Pyloromyotomy (A) Atropine (B)

Success Failure*

(n=13) (n=13) (n=9)

Onset age of vomiting (d) 28.5 20.1 29.5

Birthweight (g) 3216.2 3300.0 3030.3

Weight at admission (g) 4236.9 3774.6 3487.5

Male/Female 11/2 9/4 6/2

Ultrasonographic finding (mm)

thickness 4.8 4.5 4.6

length 18.4 17.1 17.1

diameter 14.3 13.2 13.7

* converted to surgery later on

(3)

Table 2. Complications of Atropine Therapy

Flushing Successful group (n=13)

Failed group (n=9)

Table 3. End Result by the Treatment Method

Complication rate (%) Total Hospital stay (day) Hospital stay after Tx.

Period of Sx. loss

Period to normal feeding after Tx.

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A (n=13)

0 8.9 4.1 2.8 2.9

Tachycardia 4 3

Success (n=13) 30.8 16.8 13.2 10.8 8.6

Elevation of SGOT & SGPT

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Fail (n=9) 44*

17.2 14.1 9.1 13

*: including 3 complications of atropine and 1 complication of surgery A: Pyloromyotomy, B: Atropine

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38

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