Atropine Treatment for Hypertrophic Pyloric Stenosis: A Systematic Review and Meta-Analysis
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Bibliographic record
Abstract
Introduction Several authors have reported the use of atropine as an alternative treatment to pyloromyotomy in infants with hypertrophic pyloric stenosis (HPS). Our aims were to review the efficacy of atropine in treating HPS and to compare atropine therapy versus pyloromyotomy. Materials and Methods Using a defined search strategy (PubMed, MEDLINE, OVID, Embase, Cochrane databases), two investigators independently identified studies reporting the use of atropine for HPS. Case reports and opinion articles were excluded. Outcome measures included success rate, side effects, and length of hospital stay. Maneuvers were compared using Fisher's exact test, and meta-analysis was conducted using RevMan 5.3. Data are expressed as mean ± standard deviation. Results Systematic review: of 2,524 abstracts screened, 51 full-text articles were analyzed. There were no prospective or randomized studies. Twelve articles (508 infants) reported HPS resolution using atropine in 402 (79.1%) patients. Atropine side effects were documented in 38/251 (15.1%) infants and included tachycardia, increased transaminases, and flushed skin. Meta-analysis: five studies compared atropine treatment (293 infants) with pyloromyotomy (537 infants). Pyloromyotomy had higher success rate (100%) than atropine (80.8%; p < 0.01) and shorter hospital stay (5.6 ± 2.3 vs. 10.3 ± 3.8 days, respectively; p < 0.0001). Conclusion Comparative but nonrandomized studies indicate that atropine is less effective than pyloromyotomy to treat infants with HPS. Currently, there is no evidence-based literature to support atropine treatment in these infants. To our knowledge, atropine should be reserved for patients unfit for general anesthesia or surgery.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.011 | 0.009 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it