Title

Diminishing role of contrast enema in simple meconium ileus.

Document Type

Article

Publication Date

11-1-2009

Identifier

DOI: 10.1016/j.jpedsurg.2009.06.005

Abstract

PURPOSE: Contrast enema is the initial study of choice for simple meconium ileus to confirm diagnosis and to relieve obstruction. Despite favorable historically published results, our clinical impression suggests decreased effectiveness of the contrast enema resulting in more surgical interventions in contemporary practice.

METHODS: A retrospective multiinstitutional review for a 12-year period was conducted for neonates diagnosed with meconium ileus by contrast enema. The neonates were divided into 2 groups-historic group (HG = before 2002) and contemporary group (CG = after 2002). T test was used for comparison of continuous variables and chi(2) for categorical data.

RESULTS: Thirty-seven total patients were identified (21 females and 16 males). Obstruction was relieved in 8 neonates (22% overall success rate). Average enema attempt per patient was decreased in the CG group compared to HG (1.4 vs 1.9). The success rate in the CG group was 5.5% (1/18) compared to 39% (7/18) in HG.

CONCLUSIONS: In this review, success of contrast enema for relief of meconium ileus has significantly decreased over time. These findings may be because of reluctance to repeat enemas, change in radiologist experience, or use of contrast agent. As a result, higher rates of operative intervention are now observed. In stable patients, surgeons should recommend repeat enemas before exploration.

Journal Title

Journal of pediatric surgery

Volume

44

Issue

11

First Page

2130

Last Page

2132

MeSH Keywords

Birth Weight; Cystic Fibrosis; Diatrizoate Meglumine; Enema; Female; Gestational Age; Humans; Ileus; Infant, Newborn; Male; Meconium; Preoperative Care; Radiography; Retrospective Studies; Treatment Outcome

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