Januray 1982

Improved Survival of Neonates With Meconium Ileus

Author Affiliations

From the Division of Pediatric Surgery, Department of Surgery (Drs Mabogunje and Mahour), and the Cystic Fibrosis Center, Department of Pediatrics (Dr Chun-I Wang), Childrens Hospital of Los Angeles and University of Southern California School of Medicine. Dr Mabogunje is now with the Ahmadu Bello University Hospital, Zaria, Nigeria.

Arch Surg. 1982;117(1):37-40. doi:10.1001/archsurg.1982.01380250023005

• At Childrens Hospital of Los Angeles, 48 neonates with meconium ileus (Ml) seen between 1942 and 1962 were treated surgically. Postoperative mortality was 39% for uncomplicated MI and 70% for complicated MI, with an overall survival of 23% at one year. Survival was adversely affected by the complications of surgery, postoperative bowel dysfunction, and the intestinal and pulmonary complications of cystic fibrosis (CF). From 1963 to 1980, six of 31 patients seen for Ml received diatrizoate meglumine enemas under fluoroscopic control; in three patients, disimpaction was successful and the operation was saved. In these 31 patients, postoperative mortality decreased to 11% for uncomplicated Ml and 7% for complicated Ml, with an overall survival of 71% at one year. Improvements in surgical techniques, neonatal intensive care, total parenteral nutrition, and better medical management of CF have contributed to the increased survival of patients with Ml. Although selected patients with Ml may need ileostomy. results after intestinal resection with primary anastomosis have recently been impressive.

(Arch Surg 1982;117:37-40)