| Therapeutic strategies of meconium obstruction of the small bowel in very-low-birthweight neonates. | |
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MedLine Citation:
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PMID: 20735806 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: Meconium obstruction without cystic fibrosis in low-birthweight neonates is a distinct clinical entity. We aimed to determine what therapeutic strategies work best in very-low-birthweight neonates with meconium obstruction of the small bowel under varied clinical conditions caused by the associated diseases of prematurity. Methods: Medical records of very-low-birthweight neonates with meconium obstruction of the small bowel treated from 1998 to 2008 were retrospectively reviewed. Pre- and postnatal data, treatments, and clinical outcomes were assessed. Results: Nine patients with perinatal complications were identified. Mean gestational age and birthweight were 26.9 weeks and 863 g, respectively. Abdominal distension developed from 1 to 7 days of life. Five patients were initially treated with Gastrografin enema, three of whom had successful outcomes. Two hemodynamically unstable patients failed to respond to Gastrografin treatment; they ultimately died of sepsis. The remaining four without Gastrografin treatment underwent enterostomy to resolve the obstructions with good results. Conclusions: Gastrografin and surgical treatments should be appropriately selected based on the underlying pathologies of meconium obstruction of the small bowel. Therapeutic Gastrografin enema is effective, safe and repeatable; however, it is not recommended for hemodynamically unstable patients. Surgical intervention is reserved for those who develop rapid abdominal distension that risks perforation. |
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Authors:
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Tsugumichi Koshinaga; Mikiya Inoue; Kensuke Ohashi; Kiminobu Sugito; Taro Ikeda; Ryouichi Tomita |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatrics international : official journal of the Japan Pediatric Society Volume: 53 ISSN: 1442-200X ISO Abbreviation: Pediatr Int Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-06-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100886002 Medline TA: Pediatr Int Country: Australia |
Other Details:
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Languages: eng Pagination: 338-44 Citation Subset: IM |
Copyright Information:
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© 2011 The Authors.Pediatrics International © 2011 Japan Pediatric Society. |
Affiliation:
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Department of Pediatric Surgery, Nihon University School of Medicine, Tokyo, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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