PDF(Pubmed)
Abstract：
Pylorospasm is an elusive diagnosis that can mimic the presentation of pyloric stenosis. There is limited discussion regarding its management in neonates with few case reports describing the use of antispasmodic agents. The following case reviews this management in a unique neonate. A 2-month-old female presented with persistent nonbilious, nonbloody emesis and failure-to-thrive. A thorough workup was performed due to its pronounced persistence while inpatient. Pyloric ultrasounds remained negative for pyloric stenosis; however, an upper gastrointestinal (GI) study was significant for pylorospasm. The workup also revealed hypothyroidism. Antispasmodic therapy with atropine was pursued as she was not a surgical candidate. Patient tolerated IV atropine therapy well with quick resolution of emesis and successfully transitioned to oral atropine therapy, displaying continued weight gain with exclusive oral feeds. This case displays a unique presentation of pylorospasm with successful management utilizing IV and oral atropine therapy in a neonate with failure-to-thrive and concomitant hypothyroidism.
摘要：
幽门痉挛是一种难以捉摸的诊断，可以模仿幽门狭窄的表现。关于新生儿治疗的讨论有限，很少有病例报告描述抗痉挛药的使用。以下案例在一个独特的新生儿中回顾了这种管理。一名2个月大的女性表现出持续的非胆汁性，非血腥呕吐和未能茁壮成长。由于住院期间明显的持久性，因此进行了彻底的检查。幽门超声对幽门狭窄保持阴性；然而，上消化道（GI）研究对幽门痉挛具有重要意义。检查还显示甲状腺功能减退。由于她不是手术候选人，因此继续使用阿托品进行抗痉挛治疗。患者耐受静脉阿托品治疗，呕吐迅速消退，并成功过渡到口服阿托品治疗，通过独家口服饲料显示体重持续增加。该病例表现出幽门痉挛的独特表现，并通过静脉和口服阿托品治疗成功治疗，新生儿无法茁壮成长并伴有甲状腺功能减退。
