Wu SF, et al. Efficacy of Medical Treatment for Infantile Hypertrophic Pyloric Stenosis: A Meta-analysis. Pediatr Neonatol. 2016 Dec; 57(6) :515-521.
“This meta-analysis shows that either oral or IV atropine sulfate was an effective treatment for IHPS in all but one study.
The etiology of IHPS remains unclear although several hypotheses have been postulated, including impaired function of acetylcholine and muscarinic receptors, decreased nitric oxide synthase activity, elevated prostaglandin and gastrin levels, infectious causes, and a genetic basis. [23,24,25,26,27,28]The mechanism of atropine sulfate in IHPS therapy mainly involves a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing the pyloric smooth muscles.  The effective range varies widely, perhaps because of the alterations in the muscarinic receptor sensitivity of the muscle,  variations in drug clearance, compromised blood flow secondary to pyloric spasm, lack of nitric oxide synthase, and poor innervation of the pyloric circular musculature. [23,24,30]”
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Peters B, et al. Advances in infantile hypertrophic pyloric stenosis. Expert Rev Gastroenterol Hepatol. 2014 Jul;8(5):533-41.
Infantile hypertrophic pyloric stenosis (IHPS) is a common condition in infancy, characterized by an acquired narrowing of the pylorus, which requires surgery. These infants usually present with projectile, nonbilious vomiting, with a palpable ‘olive’ in the abdomen and sometimes a ‘peristaltic wave’ after being fed with formula or breast milk. Although IHPS is a common disorder, its etiology is largely unknown. Surgical intervention is the standard treatment, preoperative preparation, however is essential to optimal outcome. In this review, the latest advances in IHPS regarding epidemiology, etiology, diagnostics and treatment will be discussed.
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