Management and survival of meconium ileus. A 30-year review

Ann Surg. 1992 Feb;215(2):179-85. doi: 10.1097/00000658-199202000-00014.

Abstract

Cystic fibrosis patients born with meconium ileus (MI) have had an improved outcome over the last three decades. The authors reviewed the impact of surgical management and long-term nutritional care on the survival of patients with MI. Of the 59 cases of MI seen from 1959 to 1989, 48 cases were managed operatively using either the Bishop-Koop ileostomy (BK), the Mikulicz ileostomy, primary resection and anastomosis (RA), or ileostomy. Six-month survival of MI has improved from 37% to 100%. Nonoperative cases (n = 11) had 100% long-term survival. The RA survivors required less late operative intervention (20%) as compared with other surgical patients (81%). A comparison of serial growth percentiles of CF patients with MI with those of their non-MI CF peers showed similar long-term decreases. These data confirm: (1) There is an improved survival for MI independent of the surgical procedure; (2) The BK ileostomy is an effective and time-tested MI treatment; (3) Primary resection and anastomosis in selected cases may have a lower surgical morbidity rate; and (4) Meconium ileus does not adversely affect the long-term nutritional outcome of CF patients.

MeSH terms

  • Chi-Square Distribution
  • Cystic Fibrosis / complications
  • Female
  • Humans
  • Ileal Diseases / congenital*
  • Ileal Diseases / mortality
  • Ileal Diseases / surgery*
  • Ileal Diseases / therapy
  • Infant
  • Infant, Newborn
  • Intestinal Obstruction / congenital*
  • Intestinal Obstruction / mortality
  • Intestinal Obstruction / surgery*
  • Intestinal Obstruction / therapy
  • Male
  • Meconium*
  • Nutritional Status
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome