Document Detail

Clinical course of obstructive jaundice associated with operated meconium peritonitis in neonates.
MedLine Citation:
PMID:  20383819     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/PURPOSE: Meconium peritonitis (MP) may induce prolonged cholestasis after laparotomy. In this study, we investigated the postoperative clinical course of MP retrospectively and discuss the relationship between MP and the development of obstructive jaundice, including biliary atresia (BA).
PATIENTS AND METHODS: Between 1979 and 2008, 23 infants with MP underwent laparotomy at our institution. Eleven of the 23 infants (47.8%) developed obstructive jaundice postoperatively. The medical charts of these 11 infants were reviewed.
RESULTS: The causative disease underlying MP included jejunoileal atresia in 10 and cloacal anomaly in 1. Of these 11 infants, 4 had acholic stools. Nine of the 11 improved with conservative management including an expectant approach, choleretic agents, and exchange blood transfusion. To differentiate the diagnosis from BA, open cholangiography was required in 2 cases following negative HIDA scintigraphy and a small gallbladder on ultrasonography. One of these 2 cases was diagnosed as BA and underwent hepatic portoeneterostomy simultaneously, after which the infant became jaundice free.
CONCLUSIONS: Postoperative cholestasis after MP was a transient condition in most cases. However, ultrasonography and HIDA scintigraphy should be performed to differentiate BA in infants with MP who show prolonged jaundice with acholic stools.
K Sakai; S Ono; S Fumino; S Shimadera; N Iwai
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-04-09
Journal Detail:
Title:  European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie     Volume:  20     ISSN:  1439-359X     ISO Abbreviation:  Eur J Pediatr Surg     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-08-18     Completed Date:  2011-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9105263     Medline TA:  Eur J Pediatr Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  222-5     Citation Subset:  IM    
Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
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MeSH Terms
Diagnosis, Differential
Follow-Up Studies
Gestational Age
Infant, Newborn
Jaundice, Obstructive / diagnosis,  etiology*,  surgery
Laparotomy / adverse effects*
Peritonitis / surgery*
Portoenterostomy, Hepatic / methods*
Retrospective Studies
Treatment Outcome

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