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Meconium ileus-like condition in Chinese neonates
P Y Chang1, F Y Huang, M L Yeh
1Division of Pediatric Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Journal of Pediatric Surgery
|September 1, 1992
Summary
Meconium ileus (MI) in neonates can be managed with Gastrograffin enema for uncomplicated cases. Albumin in meconium may indicate complications, while sweat tests were negative, suggesting cystic fibrosis is unlikely.
Area of Science:
- Neonatal Surgery
- Pediatric Gastroenterology
- Medical Research
Background:
- Meconium ileus (MI) is a significant neonatal surgical emergency.
- Early diagnosis and management are crucial for improved outcomes.
- Understanding the characteristics of MI in specific populations is important.
Purpose of the Study:
- To review the clinical presentation, management, and outcomes of meconium ileus in neonates.
- To investigate the potential role of meconium albumin content in diagnosing complicated MI.
- To evaluate the effectiveness of Gastrograffin enema in treating uncomplicated MI.
Main Methods:
- Retrospective review of 16 neonates treated for meconium ileus between 1985 and 1990.
- Analysis of patient demographics, clinical features, diagnostic methods, and treatment strategies.
- Measurement of albumin content in meconium samples.
- Performance of sweat tests for all patients.
Main Results:
- Eight patients with uncomplicated MI were successfully treated with Gastrograffin enema.
- Eight patients required surgery due to misdiagnosis or complicated MI (meconium peritonitis, ileal atresia).
- Elevated meconium albumin levels (9.2–93.3 mg/g dry meconium) were observed in complicated cases.
- All patients had negative sweat tests, ruling out cystic fibrosis.
Conclusions:
- Gastrograffin enema is an effective treatment for uncomplicated meconium ileus.
- Meconium albumin levels may serve as a biomarker for complicated MI.
- While most neonates with MI had favorable outcomes, complications and mortality can occur, necessitating careful management.