morphine and Colonic-Diseases

Meconium ileus (MI) is the earliest clinical manifestation of cystic fibrosis (CF), occurring in up to 20% of patients with CF. Our aim was to review and integrate current knowledge about the diagnosis and management of fetuses and neonates with MI that may aid the pediatric surgeon in caring for these patients.. We identified areas of interest including pathophysiology, prenatal diagnosis, nonoperative and operative management, postoperative management, and prognosis. We performed a Medline search using the search term meconium ileus for English language articles published in the last 20 years. We reviewed reference lists to identify other articles of historical significance.. Meconium ileus is primarily associated with CF transmembrane (conductance) regulator mutations F508del, G542X, W1282X, R553X, and G551D, and modifier genes have been found to explain approximately 17% of the phenotypic variability. Mouse, pig, and ferret models for CF demonstrate neonatal bowel obstruction mimicking MI. Sonographic findings of hyperechoic masses and dilated bowel in a high-risk fetus are suggestive of MI. Less than 7% of low-risk fetuses with hyperechoic bowel will have MI. Contemporary series of noninvasive management with Gastrografin enema report success rates of 36% to 39%, significantly lower than historical values. The optimal surgical technique remains controversial, although primary anastomosis results in surgical complication rates between 21% and 31%, higher than those noted with delayed anastomosis. Pulmonary function for patients with CF and MI at 15 and 25 years old is similar to those without MI, although height and weight percentiles may be lower.. This review for pediatric surgeons presents an examination of the literature and synthesizes current information about the pathophysiology, prenatal diagnosis, nonoperative and operative management, postoperative management, and prognosis of the patient with CF and MI.

Topics: Amniocentesis; Anastomosis, Surgical; Colon; Colonic Diseases; Cystic Fibrosis; Enema; Female; Fetal Diseases; Humans; Ileus; Infant, Newborn; Meconium; Pregnancy; Prognosis; Ultrasonography, Prenatal

Enterolithiasis is an uncommon finding of intraluminal calcified meconium. Whereas extraluminal calcifications are commonly reported and usually indicate intrauterine intestinal perforation with intraperitoneal extravasation of meconium (meconium peritonitis), true intraluminal calcifications of meconium in newborns are rare.. We report a case of a newborn boy with pneumothorax and pneumoperitoneum because of a transmediastinal air leakage who unfortunately died on the fifth postnatal day after a pneumopericard. The baby had lung hypoplasia and a hypoplastic thorax. Oligohydramnion was present because of urethral agenesis and anal atresia with rectourinary fistula. Enterolithiasis was found, distributed from the transverse to the rectosigmoid colon. Enterolithiasis was not diagnosed prenatally in this boy, and any of those preexisting pathologies were therefore not assumed before birth except the suspicion for urethral valves because of oligohydramnion.. Approximately 48 cases of human neonatal enterolithiasis have been described in the medical literature. The etiology of enterolithiasis appears to be intraluminal mixture of meconium und alkaline urine--as it appears in anal atresia with enterourinary fistula. Most cases of enterolithiasis are associated with major urogenital and intestinal malformations--especially VACTERL association. With support of modern high-resolution imaging devices, enterolithiasis can be detected antenatally. We suppose that prenatal diagnosis of enterolithiasis is a warning sign of underlying pathologies.

Topics: Abnormalities, Multiple; Colonic Diseases; Critical Illness; Fatal Outcome; Humans; Hydronephrosis; Infant, Newborn; Infant, Premature; Lithiasis; Male; Meconium; Pneumoperitoneum; Pneumothorax; Rectal Fistula; Urinary Fistula

Intraintestinal meconium calcification in the fetus and newborn is a rare finding, occurring in patients with intestinal obstruction. The intraluminal location of the enterolithiasis enables differentiation from calcifications that are secondary to bowel perforation and meconium peritonitis. We report on a term male neonate with VACTERL (vertebral defects, imperforate anus, cardiac anomalies, tracheoesophageal fistula, renal anomalies, limb anomalies) association and rectourethral fistula, in whom enterolithiasis was documented by prenatal ultrasound imaging at 21 weeks' gestation. A review of the literature and a summary of all previously described cases of neonates with intraluminal meconium calcifications are provided. Prenatal ultrasonographic detection of enterolithiasis in fetuses with anal atresia may indicate the presence of an enterourinary fistula.

Topics: Adult; Anus, Imperforate; Calcinosis; Colonic Diseases; Female; Humans; Infant, Newborn; Male; Meconium; Pregnancy; Rectal Fistula; Ultrasonography, Prenatal; Urethral Diseases; Urinary Fistula

Timely passage of the first stool is a hallmark of the well-being of the newborn infant. Failure of a full-term newborn to pass meconium in the first 24 hours may signal intestinal obstruction. Lower intestinal obstruction may be associated with disorders such as Hirschsprung's disease, anorectal malformations, meconium plug syndrome, small left colon syndrome, hypoganglionosis, neuronal intestinal dysplasia and megacystis-microcolon-intestinal hypoperistalsis syndrome. Radiologic studies are usually required to make the diagnosis. In addition, specific tests such as pelvic magnetic resonance imaging, anorectal manometry and rectal biopsy are helpful in the evaluation of newborns with failure to pass meconium.

Topics: Anal Canal; Colonic Diseases; Congenital Abnormalities; Diagnosis, Differential; Hirschsprung Disease; Humans; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Rectum; Syndrome

Diseases of the small colon are numerous and they can affect horses of any age. Diseases can be simple obstructions, nonstrangulating obstructions, strangulating obstructions, and congenital defects. American Miniature Horses appear prone to luminal obstruction with impacted intestinal contents, and some ischemic diseases are more common in postpartum mares. Enterotomy and enterectomy have a high success rate in the small colon, provided the affected portion can be exteriorized. The beginning and terminal portions of the small colon can be involved in many diseases and are not readily accessible from standard abdominal approaches. The prognosis is generally more favorable than has been proposed.

Topics: Animals; Animals, Newborn; Bezoars; Colon; Colonic Diseases; Female; Horse Diseases; Horses; Infarction; Intestinal Atresia; Intestinal Obstruction; Meconium; Obstetric Labor Complications; Pregnancy; Prognosis; Rupture

Topics: Abnormalities, Multiple; Colonic Diseases; Digestive System Abnormalities; Duodenal Obstruction; Esophageal Atresia; Female; Hernia; Humans; Ileum; Infant, Newborn; Intestinal Atresia; Intestinal Obstruction; Intestines; Jejunum; Male; Meconium; Megacolon; Mesenteric Cyst; Polyhydramnios; Pregnancy; Pylorus; Radiography; Vitelline Duct

Topics: Child, Preschool; Colonic Diseases; Cystic Fibrosis; Female; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestine, Small; Jejunum; Meconium; Methods

A nationwide survey on neonatal surgery conducted by the Japanese Society of Pediatric Surgeons has demonstrated that the mortality of neonatal intestinal perforation has risen over the past 15 years. The incidence of intestinal perforation in extremely low-birthweight (ELBW) neonates has been increasing as more ELBW neonates survive and as the live-birth rate of ELBW has increased. In contrast to necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP), the pathogenesis of meconium-related ileus, defined as functional bowel obstruction characterized by delayed meconium excretion and microcolon, remains unclarified.. The histology of 13 ELBW neonates with intestinal perforation secondary to meconium-related ileus was reviewed, and the radiology of 33 cases of meconium-related ileus diagnosed on contrast enema was reviewed. Specimens obtained from 16 ELBW neonates without gastrointestinal disease served as age-matched controls for histological assessment.. The size of the ganglion cell nucleus in meconium-related ileus and in control subjects was 47.3 ± 22.0 µm(2) and 37.8 ± 11.6 µm(2), respectively, which was not significantly different. In all cases of meconium-related ileus, contrast enema demonstrated a microcolon or small-sized colon, with a gradual caliber change in the ileum and filling defects due to meconium in the ileum or colon, showing not-identical locations of caliber changes and filling defects.. Morphological immaturity of ganglia was not suggested to be the pathogenesis of meconium-related ileus. Impaction of inspissated meconium is not the cause of obstruction, but the result of excessive water absorption in the hypoperistaltic bowel before birth, although the underlying mechanism responsible for the fetal hypoperistalsis remains unclear.

Topics: Colon; Colonic Diseases; Contrast Media; Diagnosis, Differential; Enema; Ganglia, Sympathetic; Gestational Age; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Infant, Very Low Birth Weight; Laparotomy; Meconium; Prognosis; Radiography, Abdominal

We are reporting the case of a neonate which died on 16th day of life due to a fatal evolution of a rare association of cystic fibrosis and Hirschsprung's disease.

Topics: Colonic Diseases; Cystic Fibrosis; Fatal Outcome; Hirschsprung Disease; Humans; Ileal Diseases; Ileus; Infant, Newborn; Male; Meconium

The case of a 36 year-old primigravida is presented. After a normal anomaly scan at 22 weeks and a normal pregnancy, she went into labor at term. Dystocia due to massive abdominal distension complicated the second stage. The newborn girl had meconium peritonitis with colonic perforation and required colonic resection with colostomy. Genetic testing detected cystic fibrosis. In this case complex meconium peritonitis developed silently (without any clinical sign) after a normal anomaly scan. This has not been reported since the start of the widespread use of obstetric ultrasound. Late meconium peritonitis can escape detection and should be thought of in cases of unexpected abdominal distension causing dystocia.

Topics: Abdomen; Adult; Colon; Colonic Diseases; Cystic Fibrosis; Dystocia; Female; Fetal Diseases; Homozygote; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy

Intraluminal meconium calculi are a rare cause of neonatal abdominal calcifications in patients with anorectal malformations. To investigate their pathogenesis, we performed infrared spectroscopic analysis of meconium-calcified lesions.. Meconium calculi were collected from the colostomy in a newborn patient with imperforate anus and rectourethral fistula. The potassium bromide method was employed to obtain the infrared absorption spectrum of the meconium calculi.. The wavelength pattern of the meconium calculi exhibited 4 specific peaks at 1570, 1390, 1105, and 1005 cm(-1) between 22% and 45% transmittance values. The unique absorption spectrum exclusively indicated ammonium hydrogen urate (C(5)N(5)O(3)H(7)), having the combined constituents of ammonium and uric acid.. These results suggest that the intraluminal meconium calculi were originally derived from meconium and fetal urine. The stasis of meconium passage and fetal urine mixing through the rectourethral fistula in a low-pH condition was deduced to be the main cause of this rare stone formation.

Topics: Anus, Imperforate; Calculi; Colon; Colonic Diseases; Humans; Infant, Newborn; Male; Meconium; Radiography; Rectal Fistula; Spectrophotometry, Infrared; Urethral Diseases; Urinary Fistula

The transverse colon is an exceptional location of intestinal duplication. Perforated duplications are rarely described in neonates. Meconium peritonitis (MP) can originate from prenatal perforated intestinal duplication. The authors report a case of a baby girl with prenatal diagnosis of MP. Rapid worsening of clinical aspects at birth and the presence of a pneumoperitoneum on systematic abdominal plain radiographs led to urgent surgery on the 1st day of life. Laparotomy showed a perforated necrotizing tubular duplication of the transverse colon. Removal of the duplication followed by limited segmental colonic resection and double colostomy were carried out. Follow-up was uneventful.

Topics: Colon; Colonic Diseases; Female; Humans; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

We reviewed the final diagnosis and incidence of bowel pathology in neonates presenting with large bowel obstruction that was relieved by the passage of meconium plugs. A retrospective case-note review was undertaken of all patients with a discharge diagnosis of meconium plug syndrome (MPS), meconium ileus (MI), Hirschsprung's disease (HD), or small left colon syndrome (SLCS) from January 1996 to April 2002. Of 21 patients with meconium plug obstruction, eight (38%) had HD, nine had MPS, four had SLCS, and none had MI. However, there was considerable clinical and radiological overlap between MPS and SLCS, suggesting that these terms are imprecise. We found a much higher incidence of HD in babies presenting with meconium plug obstruction than has previously been reported. Overlap between MPS and SLCS suggests that these are not specific diagnoses and that current terminology needs to be changed. All babies with meconium plug obstruction should have HD and cystic fibrosis (CF) excluded.

Topics: Colonic Diseases; Humans; Incidence; Infant, Newborn; Intestinal Obstruction; Meconium; Retrospective Studies

Although its pathogenesis remains still unknown, fibrosing colonopathy (FCP) is considered to be the result of prolonged treatment by high doses of pancreatic enzyme preparations, in a small proportion of patients who present with cystic fibrosis (CF). We present the case of a newborn with meconium ileus (treated by conservative measures), in which, at the age of 3 weeks, the features of intestinal obstruction made necessary the removal of 15 cm of the proximal large intestine. Macroscopical and especially microscopical appearances typical for FCP were found, despite the absence of any enzymatic treatment. These findings raised the suspicion of CF, which was confirmed 4 weeks later at necropsy by the presence of characteristic pancreatic lesions. This case and another similar report in the literature suggest that the mechanism of FCP must be linked with the disease itself, at least in some patients. Thus, for us, FCP is not a "closed subject" and we sustain the importance of continuing studies, which will shed light on its etiopathogenesis.

Topics: Colon; Colonic Diseases; Cystic Fibrosis; Dietary Supplements; Humans; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Pancreatin

The etiology of meconium obstruction without cystic fibrosis is unclear. Interstitial cells of Cajal (ICC) function as pacemakers in gut motility and may play a role in the pathophysiology of the disease.. The ICC were examined by immunohistochemical staining with anti-c-kit antibody in the bowel walls of 6 neonates who had meconium obstruction without cystic fibrosis, and the results were compared with specimens from normal neonates (n = 2).. Six patients underwent ileostomy between 2 and 15 days after birth, and 5 of them presented with microcolon. Ganglion cells were present in the ileum and colon. Whereas ICC were evenly distributed in the control specimens, they were not seen at the time of ileostomy in the colons of 2 patients, and the other 4 showed scanty distribution in muscle layers. However, ileum showed normal distribution of ICC in all patients. The ileostomies were closed between 39 and 104 days of age, and the ICC distribution was changed to a normal pattern in the colons of all 6 patients. Their bowel movements were restored to normal after closure.. The findings of this study suggest that delayed maturity of ICC may be a cause of meconium obstruction without cystic fibrosis.

Topics: Coiled Bodies; Colonic Diseases; Female; Gastrointestinal Motility; Humans; Ileal Diseases; Ileostomy; Immunohistochemistry; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

Meconium peritonitis most often is associated with congenital intestinal obstruction and meconium ileus. Uncommonly, other etiologies are identified. Hyperimmunoglobulin E syndrome (Job's syndrome) is a rare genetic disorder that is characterized by recurrent staphylococcal respiratory and skin infections in addition to elevated serum IgE levels. There have been 2 previously reported cases of intestinal complications associated with Job's syndrome. The current case is the third such case and is the first report of meconium peritonitis in a patient with hyperimmunoglobulin E syndrome. The patient presented with a meconium thorax as a result of a concurrent congenital diaphragmatic hernia.

Topics: Cecum; Colonic Diseases; Female; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Muscle, Smooth; Peritonitis; Pregnancy; Thoracic Diseases

A case of twin-to-twin transfusion syndrome with intrauterine death of one twin and meconium peritonitis and intravascular disseminated coagulation in the other twin is reported. Meconium peritonitis follows to bowel perforation, caused by segmental severe hypoplasia of muscular layer. The Authors suggest that this structural alteration of bowel wall could be an expression of inequal distribution of some cells between the two twins, during embrional development.

Topics: Adult; Colon; Colonic Diseases; Diseases in Twins; Disseminated Intravascular Coagulation; Fatal Outcome; Female; Fetal Death; Fetal Diseases; Fetofetal Transfusion; Hemoperitoneum; Humans; Ileal Diseases; Ileum; Immunoenzyme Techniques; Infant, Newborn; Intestinal Perforation; Meconium; Muscle, Smooth; Peritonitis; Polyhydramnios; Postoperative Complications; Pregnancy; Twins, Monozygotic

Neuroblastoma, Hirschsprung's disease, and central hypoventilation (Ondine's curse) are considered aberrations of neural crest cell growth, migration, or differentiation, and as such are considered to be under the general heading of neurocristopathy. Their combined occurrence in a newborn infant presenting with total colonic aganglionosis, central hypoventilation, and multifocal neuroblastoma had not been reported previously. A 2.3-kg white full-term girl required endotracheal intubation because of persistent apnea in the first hours of life. She had progressive abdominal distension and failure to pass meconium; a barium enema was performed, which showed microcolon with meconium pellets at the distal ileum. During laparotomy the distal ileum was found to be obstructed with inspissated meconium; an ileostomy and appendectomy were performed. The resected specimens were aganglionic. An additional 20 cm of aganglionic ileum was removed, and a normally innervated ileostomy was constructed. Numerous attempts at extubation failed because of apnea. The results of an extensive apnea workup, including electroencephalogram, magnetic resonance imaging (MRI), bronchoscopy, and pH probe study, were normal. Sleep studies showed congenital central hypoventilation syndrome, and the patient underwent a tracheostomy. At 3 months, an abdominal ultrasound examination performed within a septic workup showed a right suprarenal mass extending across the midline. Thoracic and abdominal MRI scans showed large bilateral adrenal and posterior mediastinal masses. The serum catecholamines and ferritin level were markedly elevated, suggestive of neuroblastoma. In light of the child's multiple problems, the family chose to forgo further workup (including a tissue biopsy) and therapy. In the following 2 months her tumor load rapidly progressed, and she died of respiratory insufficiency.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adrenal Gland Neoplasms; Colonic Diseases; Female; Follow-Up Studies; Hirschsprung Disease; Humans; Ileal Diseases; Infant, Newborn; Intestinal Obstruction; Meconium; Mediastinal Neoplasms; Neural Crest; Neuroblastoma; Sleep Apnea Syndromes; Tracheostomy

We report on a patient with atresia of the colon transversum and a large meconium pseudocyst adherent to the liver. Sonography additionally revealed multiple cystic structures due to intrahepatic meconium masses. Surgical evacuation of the meconium pseudocyst resulted in massive diffuse hemorrhage from the liver which could not be stopped. The child died intraoperatively due to hemorrhagic shock. Histologically the intrahepatic meconium masses were surrounded by various degrees of necrosis and hemorrhage without a well-defined capsule of fibrous granulation tissue.

Topics: Colonic Diseases; Cysts; Fatal Outcome; Humans; Infant, Newborn; Intestinal Perforation; Liver Diseases; Male; Meconium; Peritonitis; Ultrasonography

We have observed five children with cystic fibrosis, who presented over 2 months, with meconium ileus equivalent that failed to respond to medical management. At surgery, four had a stricture in the ascending colon, and all had histopathological changes of post-ischaemic ulceration repair, with mucosal and submucosal fibrosis. The only common change in the management of these children was a switch from conventional enteric-coated pancreatic enzymes to high-strength products 12-15 months before presentation.

Topics: Abdominal Pain; Adolescent; Child; Child, Preschool; Colon; Colonic Diseases; Constriction, Pathologic; Cystic Fibrosis; Fibrosis; Humans; Intestinal Obstruction; Lipase; Male; Meconium; Pancreatic Extracts; Pancreatin; Pancrelipase

Topics: Adult; Anus, Imperforate; Calcinosis; Colonic Diseases; Female; Fetal Diseases; Humans; Meconium; Pregnancy; Prenatal Diagnosis; Ultrasonography

Spontaneous, focal gastrointestinal perforation occurred in six very low birth weight infants. The first recognized clinical sign of perforation in five of the six infants was striking blue-black discoloration of the abdominal wall. In all cases the clinical and radiographic presentations, as well as the histologic findings, were distinct from those associated with necrotizing enterocolitis. All 4 infants who underwent exploratory laparotomy and repair had excellent surgical outcomes.

Topics: Colonic Diseases; Female; Humans; Ileal Diseases; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Intestinal Perforation; Male; Meconium; Peritonitis

Topics: Adolescent; Adult; Ascites; Bile Duct Diseases; Cecal Diseases; Child; Child, Preschool; Colonic Diseases; Cystic Fibrosis; Duodenal Diseases; Gallbladder Diseases; Gastrointestinal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Intestine, Small; Intussusception; Jaundice, Neonatal; Liver Diseases; Male; Meconium; Peritonitis; Prenatal Diagnosis; Tomography, X-Ray Computed; Ultrasonography

Meconium pleuritis developed in a neonate with a perforation of the sigmoid colon, through a diaphragmatic defect. The meconium released in the abdomen communicated with the right pleural space. The association of these defects is unusual, and the cytologic diagnosis of meconium pleuritis has not been previously reported.

Topics: Colonic Diseases; Cytodiagnosis; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pleurisy; Radiography

Intraluminal meconium calcification of unknown mechanism is reported in three neonates who did not have distal intestinal obstruction. The condition was benign in all three cases and did not require surgical intervention. This new form of intra-abdominal calcification should be differentiated from other forms that invariably are due to surgical disorders.

Topics: Calcinosis; Colonic Diseases; Humans; Ileal Diseases; Infant, Newborn; Infant, Premature, Diseases; Intestinal Diseases; Male; Meconium; Radiography

A case of meconium thorax resulting from spontaneous perforation of the colon associated with a right Bochdalek's foramen, without herniation, is presented. The baby had immediate respiratory distress postpartum resulting from the meconium in the pleural cavity. No fetal distress was detected, in spite of electrode monitoring in labor, to account for the colonic perforation.

Topics: Colonic Diseases; Female; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Pregnancy; Respiratory Distress Syndrome, Newborn; Thoracic Diseases

A newborn infant, who had suffered intrauterine perforation and had developed peritoneal calcification, showed no sign of pneumoperitoneum on the first radiograph taken 3 hours after delivery. At that time air was present in the stomach only. Subsequently pneumoperitoneum developed as air passed down the gut to the point of perforation. Thus, the absence of pneumoperitoneum on a radiograph taken very early in life does not exclude an intestinal perforation.

Topics: Colonic Diseases; Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pneumoperitoneum; Pregnancy; Radiography

Three cases of premature infants with obstruction of the ileum and proximal colon in the absence of cystic fibrosis are presented. Meconium inspissation complicated low-grade bowel obstruction in 2 infants. In the third, the bowel was anatomically normal, with the tenacious meconium the apparent primary cause of obstruction. Distinguishing features of this unusual type of blockage and other meconium syndromes are also discussed. This condition may simulate necrotizing enterocolitis, requiring surgery for differentiation. It should be considered in the differential diagnosis of low small bowel or colonic obstruction in the premature infant who is several days of age.

Topics: Colonic Diseases; Diagnosis, Differential; Enterocolitis, Pseudomembranous; Female; Humans; Ileum; Infant, Newborn; Infant, Premature, Diseases; Intestinal Obstruction; Male; Meconium; Radiography

Although NSLCS has been considered to have a benign course, we have described an infant who had intrauterine intestinal perforation and meconium peritonitis associated with the NSLCS. Infants of diabetic mothers who are stillborn or who develop abdominal distention shortly after delivery should be suspected of having this complication of NSLCS. This disorder must also be considered in the differential diagnosis of infants who present with meconium peritonitis.

Topics: Colonic Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Meconium; Peritonitis; Syndrome

Neonatal small left colon syndrome is a functional disease of the lower colon which produces typical signs and symptoms of intestinal obstruction. It is manifest in the first 24-48 hours of life, particularly in infants of diabetic mothers and, if detected early, it can be fully cured by radiographic contrast enemas, not unlike meconium plug syndrome. Intestinal perforation and death may occur, however. The etiology of the disease is unknown but it may relate to neurohumoral imbalances between the autonomic nervous system and glucagon.

Topics: Colonic Diseases; Contrast Media; Enema; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pregnancy; Pregnancy in Diabetics; Solubility; Syndrome; Water

Apparently spontaneous neonatal intestinal perforation may be difficult to diagnose if the condition is not kept in mind. It may present with free perforation or with the late effects of meconium peritonitis. Five cases are described. There is a high mortality associated with bacterial peritonitis, and the importance of early diagnosis and energetic resuscitation is underlined.

Topics: Colonic Diseases; Female; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Jejunum; Male; Meconium; Peritonitis; Rupture, Spontaneous; Stomach Rupture

Thirty dated pregnant Srague-Dawley rats received IM MgSO4 (750 mg/kg/ X 5 days) until birth. Fifteen untreated pregnant Sprague-Dawley rats of similar gestation served as controls. A total of 453 rats were born. Ninety neonates (two from each of 45 liters) were randomly removed before suckling, sacrificed, and the water content of the meconium and serum magnesium determined. The remaining 363 bewborn rats were observed for delayed passage of meconium or abdominal distention. Hypermagnesemic (6.3 +/- 0.5 mg/100 ml) neonates had neither abdominal distention nor delayed passage of meconium. The water content of meconium in hypermagnesemic rats (84.7 +/- 4.2% and in untreated controls (85.5 +/- 3.8%) were statistically similar. Dated pregnant mongrel dogs were given magnesium sulfate by continuous intravenous infusion and by bolus intravenous injection. The water content of meconium, transit time, and basic electrical rhythm (BER) of treated neonates were similar to untreated neonatal controls. The water content of meconium, transit time, and BER of neonatal dogs made hypermagnesemic (12.0 +/- 1.2 mg/100 ml) in the postnatal period were similar tp untreated neonatal controls. In adult and newborn pupies, receiving a continuous intravenous magnesium sulfate infusion, deep tendon reflexes ceased at serum magnesium levels of 9.0-10.0 mg/100 ml, spontaneous respiration at 14.0-15.0 mg/100 ml, and BER was suppressed (transiently) at 20.0-25.0 mg/10 ml. These data suggest that high (sublethal) doses of MgSO4 in pregnant and newborn animals have little effect on BER, meconium transit time or water content of the neonates. No correlation between MgSO4 treatment and the meconium plug syndrome was observed in the experiments.

Topics: Animals; Animals, Newborn; Colonic Diseases; Dogs; Female; Intestinal Obstruction; Magnesium; Meconium; Pregnancy; Pregnancy Complications; Rats; Syndrome

Topics: Barium Sulfate; Colon; Colonic Diseases; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Megacolon; Radiography

Topics: Colonic Diseases; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Megacolon; Radiography

Topics: Adolescent; Adult; Biopsy; Calculi; Colonic Diseases; Cystic Fibrosis; Esophageal and Gastric Varices; Female; Gallbladder Diseases; Gastrointestinal Diseases; Humans; Intestinal Mucosa; Intestinal Obstruction; Male; Meconium; Pneumatosis Cystoides Intestinalis; Splenomegaly

Topics: Candida; Candidiasis; Child, Preschool; Colon; Colonic Diseases; Cystic Fibrosis; Duodenum; Female; Humans; Hyperplasia; Infant; Infant, Newborn; Intestinal Obstruction; Liver Cirrhosis, Biliary; Male; Meconium; Pancreas; Submandibular Gland

Topics: Colonic Diseases; Cystic Fibrosis; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Radiography

Topics: Abdomen; Abdominal Muscles; Abnormalities, Multiple; Colonic Diseases; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Colonic Diseases; Diagnosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Laparotomy; Meconium; Postoperative Care; Radiography; Surgical Procedures, Operative

A mass of inspissated meconium in the distal colon or rectum is a relatively common cause of neonatal intestinal obstruction. The meconium-plug syndrome is unrelated to cystic fibrosis and meconium ileus. The clinical picture is frequently indistinguishable, without contrast study of the colon, from other forms of mechanical intestinal obstruction requiring laparotomy. A barium enema examination is almost always diagnostic, and use of this procedure usually results in dislodgement and passage of the plug.No single cause for the excessive viscosity and tenaciousness of the obstructive meconium mass has been identified. Previous reports have generally emphasized the normal ganglion-cell content of the colon in affected patients.Two infants are described who fulfilled all criteria for this syndrome but who were not rendered asymptomatic, as normally anticipated, by removal of the plug. Subsequent studies revealed the presence of Hirschsprung's disease in both patients. This diagnosis should be considered when an infant with meconium-plug obstruction of the colon fails to follow the usual satisfactory clinical course after the plug has been passed.

Topics: Barium Sulfate; Colonic Diseases; Colostomy; Cystic Fibrosis; Enema; Fetal Diseases; Hirschsprung Disease; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Laparotomy; Male; Meconium; Megacolon; Radiography; Rectum; Syndrome