מתוך medicontext.co.il
By C. Vidyashankar, MD
DELHI (Reuters Health) – Researchers from India report that the anticholinergic agent atropine sulfate is effective in treating infantile hypertrophic pyloric stenosis and eliminates the need for surgery.
Infantile hypertrophic pyloric stenosis results is usually treated with surgery, Dr. Utpal Kant Singh and colleagues explain in the October issue of Indian Pediatrics. The paucity of clinical trials on medical management of this condition prompted them to undertake this study, they add.
Dr. Singh and his team from the Child Care Center and Nalanda Medical College in Patna, eastern India enrolled 52 infants diagnosed with infantile hypertrophic pyloric stenosis based on clinical, radiologic and ultrasonographic findings. All infants were initially given 0.06 mg/kg per day of atropine sulfate intravenously in eight divided doses, which was gradually increased in increments of 0.015 mg/kg per day till the vomiting subsided and transit time through the pyloric sphincter was less than a minute. Following this, atropine sulfate was given orally for 3 weeks at doses double that of the last intravenous dose.
The researchers observed that 50 (96.2%) of the 52 infants responded to atropine and were asymptomatic on followup. Vomiting subsided by the third day in nearly half the infants and by the 12th day in all the infants. Two infants required surgery. Even these two showed a decrease in frequency of vomiting, the authors note.
No side effects required discontinuation of treatment in any of the patients, Dr. Singh and colleagues report. The researchers observed that the pyloric sphincter dimensions returned to normal by 15 months in all the infants, and they conclude that atropine sulfate is an "effective, cheap and safe treatment option for infantile hypertrophic pyloric stenosis."
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