Related Experiment Videos
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.
Insights
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.
Abstract:
Between January 1985 and May 1990, 16 neonates were treated for meconium ileus (MI) at this hospital. All babies were born to Chinese couples. Seven of them were premature, but none of them weighed less than 1,000 g. Eight patients underwent operations either because of mistaken diagnosis, as ileal atresia or long-segment Hirschsprung's disease, or because of complicated MI, including two meconium peritonitis and one associated with ileal atresia. Gastrograffin enema was successful in management of eight uncomplicated MI. The albumin content in the meconium of the last nine cases, including four complicated cases, ranged from 9.2 to 93.3 mg/g dry meconium. Usually, albumin is not present in normal meconium. All cases received sweat test, which were negative. Three patients died in the follow-up period. Sepsis of unknown origin, multiple congenital anomalies, and severe metabolic problems were the causes of death. The other 13 patients are doing well. They have exhibited no pulmonary or digestive problems during their follow-up period, which ranged from 11 months to 5 years. They are healthy and receive regular diets. Growth and development are appropriate for their age groups.