ABSTRACT
PURPOSE: This study investigated the risks of development and surgical complications of meconium obstruction (MO) in very low birth weight (VLBW) infants. METHODS: We performed a retrospective medical record review of VLBW infants admitted to the neonatal intensive care unit of Haeundae Paik hospital and diagnosed with MO of prematurity (MOP) between March 2010 and August 2013. RESULTS: Of 267 VLBW infants admitted to the neonatal intensive care unit, 28 were diagnosed with MOP. Perinatal factors including maternal pregnancy-induced hypertension and small for gestational age were associated with MOP development (P<0.05). Over two-thirds of VLBW infants with MOP were successfully treated with a gastrografin enema. The remaining eight VLBW infants required surgery. Although small for gestational age was more frequent in the medical treatment group, specific risk factors associated with MOP development did not affect the need for surgical intervention. CONCLUSION: MOP is common in VLBW infants, as most VLBW infants have risk factors for MOP. Identifying risk factors permits early diagnosis and initiation of appropriate medical treatment, reducing the necessity for surgery. However, the presence of specific risk factors does not increase risk of surgical complications.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Pregnancy , Diatrizoate Meglumine , Early Diagnosis , Enema , Gestational Age , Hypertension, Pregnancy-Induced , Infant, Very Low Birth Weight , Intensive Care, Neonatal , Meconium , Medical Records , Retrospective Studies , Risk FactorsABSTRACT
Primary segmental volvulus (PSV) of the ileum in neonate occurs rarely but shows an aggressive clinical course. Thus, early diagnosis is important to prevent necrosis and perforation of the intestine. We report a case of PSV of the ileum in a 2-day-old female neonate whose clinical features and radiologic findings appeared to be meconium plug syndrome.
Subject(s)
Female , Humans , Infant, Newborn , Early Diagnosis , Ileum , Intestinal Volvulus , Intestines , Meconium , NecrosisABSTRACT
Meconium plug syndrome (MPS) is the mildest and most common form of functional distal obstruction in the newborn. It is a transient obstruction of the distal colon and occasionally small bowel that is caused by inspissated immobile meconium. Neonates with MPS commonly presented with abdominal distension, bilious vomiting and problem with passage of meconium plugs. A plain abdominal radiograph often reveals generalized gaseous distention of the small bowel loops without an air-fluid level. A contrast enema is diagnostic, showing the outline of the meconium plug, and therapeutic if the plugs are passed out. In some cases of MPS there is failure to pass the meconium with the contrast enema, and emergent surgery is then required. We report here two cases of MPS that were diagnosed and treated by exploratory laparotomy and one case treated with Gastrografin enema.