Meconium Ileus

Holsclaw, Douglas S.; Eckstein, H.B.; Nixon, H. H.

doi:10.1001/archpedi.1965.02090020103003

Cited by 75 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Treatment of patients with CF is generally centered on pancreatic enzyme replacement and intensive pulmonary therapy with percussion, postural drainage, and in instances of recurrent infection antibiotics. Approximately 6% to 20% of patients with CF present during the neonatal period with meconium ileus, which is manifested by simple mechanical obturator obstruction or complications including volvulus, bowel atresia, perforation, or giant cystic meconium peritonitis [2][3][4][5]24]. In patients with an autosomal recessive genetic disorder one would anticipate a 1:4 chance of CF occurring in subsequent children.…”

Section: Genetics and Etiologymentioning

confidence: 99%

“…In 1964 Meeker and Kincannon reported on the use of N-acetylcysteine to liquefy the obstructing meconium [54]. These various procedures served to improve the survival in babies with meconium ileus, and in 1965 Holsclaw et al [4] recommended the Bishop-Koop procedure after reporting survival rates of 72%. The use of primary anastomosis was first reported by Swenson in 1962 [55].…”

Section: Bishop-koop Resectionmentioning

confidence: 99%

“…It is inherited in an autosomal recessive fashion and occurs in approximately 1:2000 live births [1]. In approximately 6% to 20% of neonates with cystic fibrosis, the meconium is highly viscid, leading to intraluminal obstruction of the terminal ileum [2][3][4][5]. Landsteiner first described this condition in 1905 after observing an obturator meconium bowel obstruction in a neonate with pathologic changes also noted in the pancreas [6].…”

mentioning

confidence: 99%

See 2 more Smart Citations

Contemporary management of meconium ileus

Rescorla

Grosfeld

1993

World j. surg.

View full text Add to dashboard Cite

Meconium ileus was noted as an early manifestation of cystic fibrosis in 60 neonates between 1972 and 1991. There were 20 girls and 40 boys. A family history of cystic fibrosis was present in six children. Twenty-five neonates had uncomplicated meconium ileus due to inspissated meconium within the terminal ileum. Thirty-five neonates presented with 56 complications of meconium ileus, including volvulus (n = 22), atresia (n = 20), perforation (n = 6), and giant cystic meconium peritonitis (n = 8). Clinical presentation included abdominal distension, bilious vomiting, and failure to pass meconium. In two recent cases, prenatal ultrasonography detected a mass with proximal bowel distension indicative of cystic meconium peritonitis. Mechanical bowel obstruction in the other neonates was diagnosed from plain abdominal radiographs and barium enema. Ten patients with uncomplicated meconium ileus were successfully treated with a diatrizoate meglumine (Gastrografin) enema. The remaining 15 patients required a laparotomy, with 9 treated by bowel resection and enterostomy and 6 recent cases managed with enterotomy and irrigation. Complicated cases were managed by bowel resection and anastomosis (n = 15) or enterostomy (n = 20). Survival at 1 year was 92% in patients with uncomplicated meconium ileus and 89% for those with complicated meconium ileus. The therapy of choice for uncomplicated meconium ileus is nonoperative Gastrografin enema, with enterotomy and irrigation reserved for enema failures. Complicated cases require exploration and, in the absence of giant cystic meconium peritonitis, are usually amenable to bowel resection and primary anastomosis.

show abstract

Section: Genetics and Etiologymentioning

confidence: 99%

Section: Bishop-koop Resectionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Contemporary management of meconium ileus

Rescorla

Grosfeld

1993

World j. surg.

View full text Add to dashboard Cite

show abstract

“…2,[5][6][7] This report describes a case of prolonged obstructive jaundice in a newborn with meconium ileus and jejunal atresia. Liver biopsy during a second operation for intestinal obstruction at 12 weeks of age showed regressing liver pathology at a time when liver disease had become clinically inapparent.…”

mentioning

confidence: 99%

Prolonged Obstructive Jaundice

Talamo¹

1968

Am J Dis Child

View full text Add to dashboard Cite

“…The incidence of neonatal cholestasis in cystic fibrosis is unclear . Neonatal cholesta sis has been reported to develop in 2-20% of meconium ileus with or without intestinal atresia (1)(2)(3). Furthermore, 50% of cholestatic neonates with cystic fibrosis have a history of meconium ileus (4)(5)(6).…”

Section: Discussionmentioning

confidence: 99%

Biliary Infusion Therapy in the Inspissated Bile Syndrome of Cystic Fibrosis

Evans,

George,

Mollit

1991

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

SummaryA 3.5‐month‐old white boy was born with meconium ileus, peritonitis, and jejunal atresia from cystic fibrosis. He subsequently developed unrelenting and severe extrahepatic biliary obstruction as demonstrated by liver biopsy showing periportal inflammation, cholestasis, and fibrosis. Surgical exploration confirmed the diagnosis of extrahepatic biliary obstruction by severely inspissated bile. A cholecystostomy tube was left in place. The cholestasis remained unresponsive to conservative medical therapy. The obstruction was relieved by hydrostatic infusion of 2% N‐acetylcysteine into the biliary tree over a 6‐day period. The child also received concurrently four i.v. injections of synthetic cholecystokinin. This therapeutic modality was thought to be both safe and effective.

show abstract

Meconium Ileus

Cited by 75 publications

References 27 publications

Contemporary management of meconium ileus

Contemporary management of meconium ileus

Prolonged Obstructive Jaundice

Biliary Infusion Therapy in the Inspissated Bile Syndrome of Cystic Fibrosis

Contact Info

Product

Resources

About