[Current status in the diagnosis and therapy of meconium ileus]

Meconium ileus is in most cases difficult to diagnose preoperatively; however, aganglionosis should be excluded in every case (rectal double-suction biopsy, manometry). In cases of uncomplicated meconium ileus (no perforation, no further intestinal obstructions) lysis of the meconium by a Gastrografin enema is tried first. In case of no relief, an intraoperative puncture of the bowel and Gastrografin instillation is performed. If there is no relief a small bowel resection is performed and a Bishop-Koop anastomosis or a chimney anastomosis established. A distinction must be made between meconium ileus, meconium disease, meconium plug syndrome, and curd obstruction. Results show a survival rate of 80%.