Article Text

PDF

1378 Meconium Obstruction in Very-Low-Birth-Weight Premature Infants
  1. E Okulu1,
  2. D Yıldız1,
  3. S Alan1,
  4. A Kılıç1,
  5. IM Akin1,
  6. B Atasay1,
  7. S Arsan1,
  8. M Koloğlu2,
  9. A Yağmurlu2,
  10. H Dindar2
  1. 1Department of Pediatrics, Division of Neonatology
  2. 2Depertment of Pediatric Surgery, Ankara University, Ankara, Turkey

Abstract

Aim Meconium obstruction(MO) is a clinical entity primarily affecting very-low-birth-weight(VLBW) premature infants. Intestinal obstruction symptoms in a VLBW infant who did not have evidence of necrotizing enterocolitis, did not have another mechanical or functional cause of obstruction defined as MO.

Method We report a series of 14 infants, whose clinical course is indicative of MO of prematurity.

Results One-hundred-thirty VLBW infants born between January 1, 2010 and December 31, 2011. Fourteen(11%) patients were diagnosed as MO. Mean gestational age and birth weight were 28.8±2.6 weeks and 943.7±238.3 g, respectively. Ninety-three percent of infants were delivered by C/S. Eight (57%) of infants had afermentioned prenatal risk factors for MO. The time of the passage of the first meconium was between 10-to-72 hours. All patients presented with distended abdomen and feeding intolerance. Abdominal plain x-rays showed multiple distended intestinal loops without air-fluid levels in all cases. Medical therapy, consisting of rectal enema with saline, if failed, enema with N-acetylcysteine was performed. Eleven of the patients underwent ileostomy surgery between posnatal age of 2-to-43 days. Nine patients (64%) survived, and the times to full enteral feeding was between day of life 13-to-81 days, the median length of hospital stay was 50 days (range 15–92 days) in these patients. One of the patients was diagnosed as Hirschsprung’s disease in the follow-up period.

Conclusion VLBW infants with MO can be diagnosed based on their typical clinical and plain radiographic characteristics. Medical management is effective, whereas some cases may need surgically management as ours.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.