What Is Meconium Ileus?

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Meconium obstruction syndrome

Meconium obstruction syndrome [Overview]

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Meconium obstruction syndrome

Meconium occlusive syndrome

Meconium occlusive syndrome refers to the low intestinal obstruction of the newborn caused by the accumulation of meconium in the rectum and sigmoid colon. It is a special type of mechanical intestinal obstruction. From the perspective of etiology, it has paralysis. Some characteristics of intestinal obstruction. In 1936, Dodd first reported the eigen. In 1956, Clatworthy named meconium obstruction syndrome, and described the characteristics in more detail. Others believe that the eigen was first described by Finkelstein in the book "Infant Diseases." This sign is more common in low-weight newborns, and about 25% occur in preterm infants. Caffey estimates that the incidence in neonates is about 1%.

Meconium obstruction syndrome [Etiology, Pathology]

The true cause is unknown. Some people believe that neonatal hypermagnesemia is the causative factor. Pregnant women with eclampsia can cause fetal blood to contain too much magnesium after anticonvulsant treatment with a larger amount of magnesium sulfate. It is generally believed that when the concentration of blood magnesium exceeds 108mmoL / L, symptoms of poisoning may occur, inhibiting the central and peripheral nervous system, and causing paralysis of striated and smooth muscles, resulting in dull reflexes, muscle relaxation, weakness, abdominal distension, and colonic peristalsis. Meconium cannot be excreted and remains in the sigmoid colon and rectum. After the large amount of water in the meconium is absorbed by the colon, the surface tension of the meconium can be increased and the agglomeration can be concentrated. Clatworthy believes that abnormal meconium composition and weakened bowel movements are the main reasons for this. In addition, premature birth, low body weight, hypoxia, hypothermia, childbirth injuries, and medications for pregnant women can cause colonic motility abnormalities in newborns, leading to the occurrence of intrinsic symptoms.

Meconium obstruction syndrome [Clinical manifestations]

The newborn had no meconium excretion within 2 days after birth, the abdomen gradually expanded, and bile vomiting could occur, and bowel sounds weakened or disappeared. Shows a series of symptoms of low bowel obstruction.

Meconium obstruction syndrome [Diagnosis]

Digital rectal examination can find that the anal canal is tight and can touch thick meconium blocks. Meconium contamination and a large amount of gas can be seen when the fingers are pulled out. After a proper amount of saline is used for enema, the symptoms of meconium obstruction can be cleared. Newborn finger tests should be performed with the little finger of the right hand, preferably without the index finger.

Abdominal X-ray examination is helpful to confirm the diagnosis. Diffuse gas in the small intestine and colon can be seen, which indicates low colonic obstruction. Barium low pressure enema imaging shows normal intestinal diameter and multiple elongated transparent areas in the colon.

Meconium obstruction syndrome [Differential diagnosis]

Must be distinguished from congenital megacolon and meconium intestinal obstruction. In addition to the method of identification, in addition to X-ray examination, saline enema can be used. If the obstruction can be relieved and meconium is excreted, this is the syndrome; otherwise, giant colon and meconium intestinal obstruction should be considered. The trypsin in meconium was normal, and the determination of sweat nitride was not increased, which could distinguish the characteristics from meconium intestinal obstruction.

Meconium obstruction syndrome [Treatment]

For those who are unable to excrete meconium by themselves after 24 hours of birth, the meconium can be extracted by digital rectal examination or an appropriate amount of normal saline for enema to excrete meconium, relieve obstruction, and the abdominal distension disappears. After the children with this syndrome are cured, they should be followed up for 1 to 2 weeks.