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Clinical course of obstructive jaundice associated with operated meconium peritonitis in neonates

K Sakai1, S Ono, S Fumino

  • 1Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|April 13, 2010
PubMed
Abstract

Insights

Meconium peritonitis (MP) can cause prolonged jaundice in infants. Most cases resolve with conservative treatment, but imaging is crucial to rule out biliary atresia (BA) in persistent cases.

Area of Science:

  • Pediatric Surgery
  • Neonatal Gastroenterology
  • Hepatology

Background:

  • Meconium peritonitis (MP) is a rare neonatal condition that can lead to prolonged cholestasis post-laparotomy.
  • Obstructive jaundice, including biliary atresia (BA), is a potential complication in infants with MP.

Purpose of the Study:

  • To retrospectively analyze the clinical course of infants with MP.
  • To investigate the association between MP and the development of obstructive jaundice.
  • To differentiate MP-associated jaundice from biliary atresia (BA).

Main Methods:

  • Retrospective review of 23 infants with MP who underwent laparotomy between 1979 and 2008.
  • Analysis of clinical data for 11 infants who developed postoperative obstructive jaundice.
  • Utilized ultrasonography, HIDA scintigraphy, and open cholangiography for diagnosis.

Main Results:

  • Of 23 infants with MP, 11 (47.8%) developed obstructive jaundice.
  • Jejunoileal atresia was the underlying cause in 10 infants; cloacal anomaly in 1.
  • Nine of 11 infants improved with conservative management; 2 required further investigation for BA.

Conclusions:

  • Postoperative cholestasis following meconium peritonitis is typically transient.
  • Ultrasonography and HIDA scintigraphy are essential to differentiate BA in infants with MP and prolonged jaundice with acholic stools.

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