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European Paediatric Surgeons' Association Consensus Statement on the Management of Meconium Ileus

Amulya K Saxena1,2, Romilly K Hayward1,2,3, Annika Mutanen4,5

  • 1Chelsea and Westminster Hospital NHS Foundation Trust, Department of Paediatric Surgery, England, United Kingdom of Great Britain and Northern Ireland, London.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|June 29, 2026
PubMed

Insights

Pediatric surgeons reached a consensus on managing meconium ileus (MI). Contrast enemas are recommended for diagnosis and initial treatment in simple cases, while surgery is advised for complex or resistant cases.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Neonatal Care

Background:

  • Meconium ileus (MI) management lacks a unified consensus among pediatric surgeons regarding diagnostics, treatment, and outcomes.
  • The European Paediatric Surgeons' Association (EUPSA) identified this gap, leading to a dedicated consensus session.

Purpose of the Study:

  • To establish evidence-based recommendations for the diagnosis and management of meconium ileus (MI).
  • To provide a unified approach for pediatric surgeons facing MI cases, including diagnostic modalities, conservative strategies, and surgical interventions.

Main Methods:

  • A structured literature review was performed across major databases (Cochrane, Medline, EMBASE) up to April 2024.
  • A panel of nine EUPSA-appointed pediatric surgeons reviewed evidence and formulated recommendations.
  • Consensus statements were refined through iterative discussion and feedback from congress participants.

Main Results:

  • Contrast enema is recommended as the primary diagnostic tool and first-line treatment for uncomplicated MI.
  • Surgical intervention is indicated for complicated MI or cases unresponsive to conservative management.
  • Enterostomy is a common surgical approach, with technique tailored to intraoperative findings; stoma reversal requires multidisciplinary assessment.

Conclusions:

  • A peer-reviewed consensus statement offers pragmatic guidance for pediatric surgeons in diagnosing and managing MI.
  • The consensus highlights the role of contrast enema in uncomplicated MI and surgery for complicated disease.
  • This EUPSA-recognized resource aids clinical decision-making in pediatric meconium ileus management.
Abstract

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