Meconium ileus secondary to cystic fibrosis
The East London experience |
| |
Authors: | I Mushtaq V M Wright D P Drake M B Mearns C B S Wood |
| |
Institution: | (1) Department of Paediatric Surgery, Queen Elizabeth Hospital for Children, Hackney Road, London, U.K., GB;(2) Department of Paediatric Medicine, Queen Elizabeth Hospital for Children, Hackney Road, London, U.K., GB |
| |
Abstract: | Meconium ileus (MI) affects 15% of neonates with cystic fibrosis (CF). The authors reviewed the management and outcome of
51 neonates presenting to a single institution between 1976 and 1995 with MI secondary to CF. Clinical presentation included
abdominal distension (96%), bilious vomiting (49%), and delayed passage of meconium (36%). A family history of CF was present
in 4 cases (8%). Twenty-three neonates presented with MI and evidence of volvulus, atresia, or perforation (complicated MI).
Of these, 16 underwent stoma formation, 1 appendicectomy, and 6 resection with primary anastomosis. Twenty-eight neonates
presented with uncomplicated MI. Of these, 11 were managed non-operatively by Gastrografin enema (10) or enteral N-acetylcysteine
(1). The remainder required stoma formation (15) or bowel resection with primary anastomosis (2). Early postoperative complications
occurred in 2 neonates (4%). In this hospital the 1-year survival for this condition has increased from 49% (1953–1970) to
98% (1976–1995) irrespective of the surgical procedure performed or the presence of volvulus, atresia, or perforation. In
our experience, bowel resection with primary anastomosis is as safe as stoma formation and is associated with a reduced length
of initial hospital stay.
Accepted: 23 October 1997 |
| |
Keywords: | Meconium ileus Cystic fibrosis |
本文献已被 SpringerLink 等数据库收录! |
|