Document Detail

Diminishing role of contrast enema in simple meconium ileus.
MedLine Citation:
PMID:  19944221     Owner:  NLM     Status:  MEDLINE    
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.
Daniel R Copeland; Shawn D St Peter; Susan W Sharp; Saleem Islam; Alex Cuenca; Joshua S Tolleson; Melvin S Dassinger; Danny C Little; Richard J Jackson; Evan R Kokoska; Samuel D Smith
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  44     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-30     Completed Date:  2010-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2130-2     Citation Subset:  IM    
Arkansas Children's Hospital, Little Rock, AR 72202-3591, USA.
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MeSH Terms
Birth Weight
Cystic Fibrosis / complications*,  surgery
Diatrizoate Meglumine / diagnostic use
Enema / methods*,  utilization
Gestational Age
Ileus / radiography*,  surgery,  therapy*
Infant, Newborn
Meconium / radiography*
Preoperative Care / methods
Retrospective Studies
Treatment Outcome
Reg. No./Substance:
131-49-7/Diatrizoate Meglumine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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