Related Experiment Videos
T-tubes in the management of meconium ileus
1Department of Pediatric Surgery, Bnai-Zion Medical Center, P. O. B. 4940, Haifa, 31048 Israel
Insights
T-tube (TT) ileostomy effectively treated meconium ileus (MI) in infants who did not respond to conservative care. This surgical approach proved safe for uncomplicated MI and beneficial for complicated cases requiring anastomosis.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Meconium ileus (MI) is a significant cause of intestinal obstruction in neonates.
- Conservative management is the initial approach, but surgical intervention is sometimes necessary.
Purpose of the Study:
- To evaluate the efficacy and safety of T-tube (TT) ileostomy in managing meconium ileus.
- To assess outcomes in both uncomplicated and complicated cases of MI.
Main Methods:
- Retrospective review of 8 infants with meconium ileus treated surgically between 1986 and 1995.
- All patients underwent enterotomy with T-tube (TT) placement; complicated cases had pre-anastomotic enterotomies.
Main Results:
- Surgical relief of obstruction was achieved in all 8 cases.
- Six uncomplicated cases had no stoma or bowel resection.
- Complicated cases included meconium peritonitis with pseudocyst/atresia and small-bowel volvulus with necrosis.
- Two complications occurred: one mortality from respiratory failure and one relaparotomy for adhesions.
Conclusions:
- T-tube (TT) ileostomy is an effective and safe surgical option for meconium ileus unresponsive to conservative treatment.
- The procedure is suitable for both uncomplicated MI and complicated cases necessitating an anastomosis.
Abstract:
Fifteen cases of meconium ileus (MI) were treated between 1986 and 1995; 7 responded to conservative treatment. Eight were operated upon, and comprise the study group. Six of the operated babies had no complications; 1 had meconium peritonitis with a pseudocyst and small-bowel atresia, and 1 had a volvulus of a small-bowel segment with necrosis. In all 8 cases a T-tube (TT) was left via an enterotomy; in the complicated cases the enterotomy was pre-anastomotic. The obstruction was relieved in all the babies, without any stoma or bowel resection in the uncomplicated cases. Two complications occurred: 1 patient died of respiratory failure 1 month following surgery and another required a relaparotomy for lysis of adhesions. We conclude that TT ileostomy is an effective and safe procedure for uncomplicated cases of MI that do not respond to conservative therapy, as well as for complicated cases that need an anastomosis.