Meconium Obstruction in Neonates-Clinical Characteristics and Treatment.
- Author:
Eun Young CHANG
1
;
Mi Jung LEE
;
Myung Joon KIM
;
Jae Ho SHIN
;
Hye Kyung CHANG
;
Seok Joo HAN
;
Jung Tak OH
Author Information
1. Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul, Korea. jtoh@yuhs.ac
- Publication Type:Original Article
- Keywords:
Meconium obstruction;
Neonate;
Very low birth weight;
Hirschsprung's disease
- MeSH:
Birth Weight;
Enema;
Gestational Age;
Hirschsprung Disease;
Humans;
Incidence;
Infant, Newborn;
Infant, Very Low Birth Weight;
Meconium;
Retrospective Studies
- From:Journal of the Korean Association of Pediatric Surgeons
2011;17(1):15-22
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Meconium obstruction (MO) in neonates arises from highly viscid meconium and the poor motility of the premature gut. Recently the incidence of the MO in neonates has been increasing, but, the diagnosis and treatment of this disease have not yet been clarified. Between March 2004 and April 2010, 24 neonates were treated for MO at Severance Children's Hospital. Their clinical characteristics and treatment were reviewed retrospectively. Twenty neonates were diagnosed with MO and 4 neonates were diagnosed with Hirschsprung's disease (HD). The mean birth weight and gestational age of the 20 neonates with MO were 1.45+/-0.90kg and 31.1+/-4.6 weeks, respectively. Thirteen neonates (65%) diagnosed with MO weighed less than 1.5kg and 10 neonates (50%) weighed less than 1kg. Half of the neonates with MO were treated by non-operative methods and the other half were treated by operative methods. Compared with the group that weighed over 1.5kg, the group that weighed less than 1.5kg were more frequently operated upon (61.5% vs. 28.5%), and contrast enemas were performed later and more frequently. Also the group that weighed less than 1.5kg had a higher mortality rate (15.4% vs. 0%). Three of the four neonates with HD were diagnosed with long-segment aganglionosis. In conclusion, MO occurred in very low birth weight neonates more often and must be differentiated from HD. Also, MO in very low birth weight neonates should be treated with special attention due to more a complicated clinical course.
