Korean J Pediatr Gastroenterol Nutr.  2011 Mar;14(1):52-58. 10.5223/kjpgn.2011.14.1.52.

Meconium Obstruction in Very Low Birth Weight Infants

• Hong KB
• Seong IC
• Lee KS
• Chang YP
• Song HS

• KMID: 1451206
• DOI: http://doi.org/10.5223/kjpgn.2011.14.1.52

Abstract

PURPOSE
Mecnoium obstruction in very low birth weight infants (VLBWI), which delays enteral feeding and is one of the major causes of bowel obstruction, can be diagnosed and treated with hyperosmolar water-soluble contrast enema. The purpose of this study was to observe the clinical findings of meconium obstruction, the improvement of small bowel obstruction after contrast enema, and the complications related to the enema.
METHODS
Hypersolmolar water-soluble contrast enemas were performed in 14 VLBWIs with meconium obstruction. Clinical findings, radiologic findings, feeding intolerance, effectiveness, and complications of enemas were observed. Also, clinical findings related to meconium obstruction were compared with 18 VLBWIs without meconium obstruction.
RESULTS
1) Fourteen VLBWIs with meconium obstruction had significantly lower 5 minutes Apgar scores than 18 VLBWIs without meconium obstruction (p<0.05). Moreover, the day of last meconium passing, and the day of the first trial and full enteral feeding were delayed significantly. 2) A total of 18 enemas were performed in the 14 infants. The contrast medium passed the ileocecal valve and reached the terminal ileus in 12 enemas. Of the 12 enemas, 11 were successful, but 1 infant underwent an ileotomy, even though the contrast medium reached the terminal ileum. 3) Intestinal obstruction was not relieved in three of five infants, in whom the contrast medium failed to pass the ileocecal valve. Obstruction was relieved after repeated enemas in which the contrast medium reached the terminal ileum. 4) No complications associated with water-soluble contrast enemas were observed.
CONCLUSION
Hyperosmolar water-soluble contrast enema is considered to be safe and therapeutic for meconium obstruction in VLBWIs.

Keyword

Infant; Low birth weight; Contrast media; Enema; Meconium; Ileus

MeSH Terms

Contrast Media
Enema
Enteral Nutrition
Humans
Ileocecal Valve
Ileum
Ileus
Infant
Infant, Low Birth Weight
Infant, Newborn
Infant, Very Low Birth Weight
Intestinal Obstruction
Meconium
Contrast Media

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