Document Detail


Is it necrotizing enterocolitis, microcolon of prematurity, or delayed meconium plug? A dilemma in the tiny premature infant.
MedLine Citation:
PMID:  8783123     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Failure of a small premature newborn to adequately evacuate meconium for days or weeks has been attributed to "probable necrotizing enterocolitis (NEC)" or "microcolon of prematurity." The authors present an unusual type of "meconium plug syndrome" with the same clinical picture, seen in tiny premature babies (500 to 1,500 g), which required a contrast enema or Gastrografin upper gastrointestinal (UGI) series to evacuate the plugs. The obstruction resolved. Twenty babies (480 to 1,500 g) presented with the same clinical picture without any x-ray suggestion of NEC; contrast enemas were performed because of the suspicion of meconium plug syndrome. All 20 had extensive meconium plugs that were evacuated by the enema or by a Gastrografin UGI series. Most of them improved after the plugs were passed. These infants differ from typical full-term babies with meconium plug syndrome in a number of ways: (1) many of the mothers were on magnesium sulfate (MgSO4) or had eclampsia; (2) the plugs were diagnosed late rather than shortly after birth; and (3) the plugs were significant, extending to the right colon. The authors believe that when a tiny premature baby has findings consistent with meconium plug syndrome, the baby should be transported to radiology, for a Gastrografin enema, despite the difficulties involved. Delay postpones the start of feedings, and increases the number of radiographic studies.
Authors:
I H Krasna; D Rosenfeld; P Salerno
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  31     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1996-11-14     Completed Date:  1996-11-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  855-8     Citation Subset:  IM    
Affiliation:
Department of Radiology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903-0019, USA.
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MeSH Terms
Descriptor/Qualifier:
Contrast Media / therapeutic use
Diagnosis, Differential
Diatrizoate Meglumine / therapeutic use
Enterocolitis, Pseudomembranous / complications,  diagnosis*
Female
Humans
Infant, Newborn
Infant, Premature, Diseases / diagnosis*
Infant, Very Low Birth Weight*
Intestinal Obstruction / etiology*,  therapy
Meconium*
Pregnancy
Pregnancy Complications
Chemical
Reg. No./Substance:
0/Contrast Media; 131-49-7/Diatrizoate Meglumine

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


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