Abstract
Purpose
Contrast enema is the initial study of choice for simple meconium ileus to confirm
diagnosis and to relieve obstruction. Despite favorable historically published results,
our clinical impression suggests decreased effectiveness of the contrast enema resulting
in more surgical interventions in contemporary practice.
Methods
A retrospective multiinstitutional review for a 12-year period was conducted for neonates
diagnosed with meconium ileus by contrast enema. The neonates were divided into 2
groups—historic group (HG = before 2002) and contemporary group (CG = after 2002).
T test was used for comparison of continuous variables and χ2 for categorical data.
Results
Thirty-seven total patients were identified (21 females and 16 males). Obstruction
was relieved in 8 neonates (22% overall success rate). Average enema attempt per patient
was decreased in the CG group compared to HG (1.4 vs 1.9). The success rate in the
CG group was 5.5% (1/18) compared to 39% (7/18) in HG.
Conclusions
In this review, success of contrast enema for relief of meconium ileus has significantly
decreased over time. These findings may be because of reluctance to repeat enemas,
change in radiologist experience, or use of contrast agent. As a result, higher rates
of operative intervention are now observed. In stable patients, surgeons should recommend
repeat enemas before exploration.
Key words
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Article info
Publication history
Accepted:
June 1,
2009
Received in revised form:
May 28,
2009
Received:
February 6,
2009
Identification
Copyright
© 2009 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
