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Published on: March 10, 2015
[Clinical and therapeutical considerations regarding the diagnosis and treatment in meconial disease]
C Sabetay1, O Ciobanu, A Zavate
1Clinica Chirurgie Pediatrică, Spitalul Clinic de Urgenţă, Craiova. sabetay@umfcv.ro
Insights
Meconium disease, including ileus and peritonitis, significantly impacts newborn survival, with mortality rates between 30-50%. Surgical interventions for meconium disease show a 37.5% mortality, highlighting the need for improved treatment strategies.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Diseases
Context:
- Meconium disease, encompassing meconium ileus and peritonitis, poses a critical threat to newborn prognosis.
- Associated with cystic fibrosis, it increases disease severity and impacts overall patient outcomes.
- High mortality rates (30-50%) underscore the urgency of effective management.
Purpose:
- To evaluate treatment outcomes for meconium disease in a pediatric surgery clinic over a decade.
- To analyze diagnostic challenges, preoperative care, and surgical treatment modalities.
- To assess the effectiveness of surgical interventions in managing meconium ileus, plug, and peritonitis.
Summary:
- A 10-year study reviewed 16 cases of meconium ileus, plug, and peritonitis.
- Surgical treatments included bowel defect repair, resection with anastomosis, and ileostoma.
- Despite advancements in postoperative care, the mortality rate in the studied cohort was 37.5%.
Impact:
- The study highlights the persistent challenges and significant mortality associated with meconium disease in newborns.
- Findings emphasize the need for refined diagnostic and surgical approaches to improve survival rates.
- Results provide valuable data for pediatric surgeons and neonatologists managing these complex cases.
Abstract:
The meconium disease represents a problem of great impact over the vital prognosis of the newborn, the mortality of this disease being rated in various studies between 30 and 50%. The meconial disease that reunites the meconial ileus and the meconial peritonitis is often associated with cystic fibrosis a disease of general impact over the entire organism increasing the gravity and influencing the vital prognosis of these patients. The authors' purpose is to evaluate the results obtained after the treatment of the meconial disease in the Pediatric Surgery Clinic of the Emergency Hospital of Craiova over a period of 10 years. The study has been made on a number of 16 cases of meconial ileus, plug and peritonitis analising the difficulty of the diagnostic process, the preoperative care as well as the possibilities of surgical treatment. The surgical treatment is composed of multiple procedures including simple suture of the bowel defect and segmentary bowel resections with primary anastomosis and/or secondary anastomosis after ileostoma. The mortality on the studied cases was of 37.5% despite recent progresses achieved in postoperative care of these type of patients.
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