Meconium Ileal Obstruction and Functional Immaturity: Review
Lisieux Eyer de Jesus1, Tania Cristina Lund1, Claudia Tavares Regadas1
1Department of Pediatric Surgery, Hospital Federal dos Servidores do Estado, Brazilian Ministry of Health, Rio de Janeiro, Brazil.
Journal of Pediatric Surgery
|October 2, 2024
Summary
Ileal obstruction due to thick meconium in premature infants (IOMFI) often presents with abdominal distension. Early diagnosis and water-soluble contrast enemas are key to successful treatment, with surgery reserved for complications.
Area of Science:
- Neonatalogy
- Pediatric Surgery
- Gastroenterology
Background:
- Ileal obstruction caused by thick meconium associated with functional immaturity (IOMFI) is an uncommon condition in premature infants.
- Late or incorrect diagnosis of IOMFI poses significant challenges.
- Understanding IOMFI's clinical profile and treatment is crucial.
Purpose of the Study:
- To review the clinical characteristics of IOMFI.
- To examine the therapeutic approaches for IOMFI.
Main Methods:
- A critical descriptive literature review was conducted.
- Analysis of clinical data and treatment outcomes from existing studies.
Main Results:
- Premature infants often develop IOMFI in their second week of life, presenting with abdominal distension.
- Radiological findings include diffuse intestinal distention and a distal ileal caliber transition zone.
- Most patients respond to water-soluble contrast enemas, with surgery indicated for non-responders or perforations.
Conclusions:
- Literature on IOMFI is limited, often based on small, heterogeneous cohorts.
- Successful treatment with contrast enemas depends on reflux through the ileocecal valve and early intervention.
- Real-time ultrasound or intermittent radiography can guide contrast inflow during enema administration.
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