-Case Reports-

Intravenous Atropine Treatment in Hypertrophic Pyloric Stenosis: Evaluation by Clinical Course and Imaging

Makiko Asai, Yasuhiro Katsube, Yuuko Takita, Takuya Okada, Miharu Hajikano, Mariko Fujimatsu, Mitsuhiro Kamisago, Yoshiki Nishizawa and Takehisa Fujita

Department of Pediatrics, Nippon Medical School Musashi Kosugi Hospital

Hypertrophic pyloric stenosis (HPS) is the principal disease to consider in neonates presenting with frequent projectile vomiting and poor weight gain. Ramstedt pyloromyotomy is commonly used for the surgical treatment of HPS. The present study investigated the efficacy of nonsurgical medical treatment using intravenous administration of atropine and the examined the clinical course and results of ultrasonography and a contrast upper gastrointestinal series. A 34-day-old girl was admitted with chief complaints of projectile vomiting and poor weight gain. HPS was diagnosed on the basis of the clinical course and results of imaging studies. After intravenous administration of atropine, projectile vomiting resolved and weight increased without complications. On imaging studies, barium introduced into the stomach by tube rapidly entered the duodenum after atropine administration. Ultrasonography initially showed no reductions in hypertrophic muscle in the pyloric region, but gradual reductions were identified in subsequent months.

J Nippon Med Sch 2007; 74: 50-54

Keywords
hypertrophic pyloric stenosis, atropine, contrast upper gastrointestinal series, ultrasonography

Correspondence to
Makiko Asai, MD, Department of Pediatrics, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
maki-asa@nms.ac.jp

Received, September 20, 2006
Accepted, November 21, 2006