[HTML][HTML] Issues in the management of simple and complex meconium ileus
A Karimi, RR Gorter, C Sleeboom… - Pediatric surgery …, 2011 - Springer
A Karimi, RR Gorter, C Sleeboom, CMF Kneepkens, HA Heij
Pediatric surgery international, 2011•SpringerIntroduction Various surgical methods are used to treat meconium ileus (MI), including
resection with enterostomy (RES), primary anastomosis (RPA), and purse-string enterotomy
with intra-operative lavage (PSI). The aim of this study is to discuss the surgical treatment of
MI, based on our experience. Patients and methods Of the 41 MI patients treated at our
institution between 1984 and 2007, 18 had simple MI and 23 had complex MI. These groups
were analyzed according to treatment modality, concentrating on length of hospital stay …
resection with enterostomy (RES), primary anastomosis (RPA), and purse-string enterotomy
with intra-operative lavage (PSI). The aim of this study is to discuss the surgical treatment of
MI, based on our experience. Patients and methods Of the 41 MI patients treated at our
institution between 1984 and 2007, 18 had simple MI and 23 had complex MI. These groups
were analyzed according to treatment modality, concentrating on length of hospital stay …
Introduction
Various surgical methods are used to treat meconium ileus (MI), including resection with enterostomy (RES), primary anastomosis (RPA), and purse-string enterotomy with intra-operative lavage (PSI). The aim of this study is to discuss the surgical treatment of MI, based on our experience.
Patients and methods
Of the 41 MI patients treated at our institution between 1984 and 2007, 18 had simple MI and 23 had complex MI. These groups were analyzed according to treatment modality, concentrating on length of hospital stay, complications [peritonitis, septicemia, adhesive small bowel obstruction (ASBO), and malabsorption/diarrhea], need for additional surgical procedures, mortality.
Results
Of the 18 patients with simple MI, 7 (39%) were successfully treated with diluted Gastrografin® enema. The remaining 11 patients were treated surgically: two underwent RPA, of whom one died; five had RES, of whom one developed ASBO; four underwent PSI, of whom two developed peritonitis. In the complex MI group, 14 patients underwent RPA, with peritonitis occurring in three (one died); nine underwent RES, of whom two developed ASBO.
Conclusion
In patients with simple MI, conservative treatment with diluted Gastrografin® enema is an effective initial treatment in our hands. In case of failure, RES is advisable. Patients with complex MI are candidates for RES. RPA and PSI seem to have higher complication rates.
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