morphine and Jejunal-Diseases

We present two cases of fetal meconium peritonitis in a single and twin pregnancy, respectively. The first case diagnosis was made at 30 weeks and was confirmed after delivery of the twins by cesarean section at 37 weeks. The second case diagnosis was made at 31 week and was confirmed at 37 weeks. Meconium peritonitis is a rare prenatal complication that results from intrauterine perforation of small bowel with spillage of sterile meconium into peritoneal cavity. We now report two cases of meconium peritonitis diagnosed at 30 and 31 weeks gestation.

Topics: Adult; Diagnosis, Differential; Female; Fertilization in Vitro; Fetal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Jejunal Diseases; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Pregnancy, Multiple; Twins; Ultrasonography, Prenatal

During 13 years, 47 infants were treated for mechanical ileus resulting from intestinal obstruction located proximally to the coecum (duodenal obstruction, malrotation, jejuno-ileal obstruction and meconium ileus). The mortality and morbidity were low. A total of three infants died; all of them in the immediate postoperative period. One infant died on account of rupture of the anastomosis; in two infants, death was caused by pulmonary complications and disseminated intravasal coagulation. Seven reoperations were performed and among these five infants on account of adhesions-/fibrous band ileus. At follow-up examination five infants were slightly underweight and retarded in growth; only one child had troublesome gastrointestinal problems. We recommend the use of antenatal ultrasound in the 30th week of gestation more frequently and always when polyhydramnios is present. This should raise the suspicion of gastrointestinal obstruction. Postnatal screening for associated congenital anomalies should also be done, since these are the most frequent cause of death in this patient category.

Topics: Duodenal Obstruction; Female; Follow-Up Studies; Humans; Ileal Diseases; Infant; Infant, Newborn; Intestinal Obstruction; Jejunal Diseases; Male; Meconium; Prognosis

A study of 29 neonates with intestinal obstruction has shown that a massively dilated, bulbous terminal segment of bowel is characteristic of neonatal infestinal obstruction of congenital origin. The sign is an important diagnostic indicator but its absence does not exclude intestinal atresia.

Topics: Dilatation, Pathologic; Humans; Ileal Diseases; Ileum; Infant, Newborn; Intestinal Obstruction; Intestine, Small; Jejunal Diseases; Jejunum; Meconium; Radiography; Retrospective Studies