Meconium peritonitis: A 22-year review in a tertiary referral center

Wong, C. K.; Wong, Kenneth Kak Yuen

doi:10.1016/j.jpedsurg.2021.10.006

Cited by 6 publications

(7 citation statements)

References 19 publications

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“…This study demonstrated that whether MP is diagnosed prenatally or postnatally, there is no correlation with complications, abandonment, or mortality rates like as Wong's study [7]. The most common complications in both groups were incision infection and cholestasis, with incision infection rates of 8.7% and 12.5% in the prenatal and postnatal diagnosis groups, respectively, slightly higher in the postnatal diagnosis group.…”

Section: Postoperative Indicatorsmentioning

confidence: 52%

“…Regarding the potential for prenatal diagnosis, different centers hold various perspectives. Chen's opinions suggest that prenatal diagnosis aids in early transport to pediatric centers[6], while Wong [7] argue that the prognosis between prenatal and postnatal diagnoses appears to be similar. For this reason, we conducted a study in our institution analyzing the cases diagnosed prenatally and postnatally, aiming to assess the impact of prenatal or postnatal diagnosis on meconium peritonitis.…”

Section: Introductionmentioning

confidence: 99%

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Does prenatal diagnosis of meconium peritonitis have the better recovery? A single-center over 10 years of experience

Li,

Lu,

Wang

et al. 2024

Pediatr Surg Int

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Objective: To evaluate whether infants with prenatal diagnosis of meconium peritonitis (MP) have a poorer prognosis. Methods: A retrospective analysis of data from infants treated with surgery from January 2008 to December 2020 was conducted. The patients were divided into prenatal diagnosis group and postnatal diagnosis group based on the timing of diagnosis. The intraoperative and postoperative parameters of the two groups of patients were compared. Results: A total of 71 cases of MP were included in the study, with 48 cases in the prenatal diagnosis group and 23 cases in the postnatal diagnosis group. The comparison of preoperative indicators between the two groups of patients showed no statistically signi cant differences in baseline (P>0.05). Intraoperative indicators, including blood loss, anastomosis, retained intestinal tube length, and excised intestinal tube length, showed no statistically signi cant differences between the two groups (P>0.05). However, the postnatal diagnosis group had a signi cantly shorter operation time than the prenatal diagnosis group (P<0.05). Postoperative indicators, including fasting time, albumin usage, complications, and abandonment or mortality rate (P>0.05). Nevertheless, the postnatal diagnosis group exhibited signi cantly shorter hospital stay and time to rst bowel movement compared to the prenatal diagnosis group (P<0.05). Conclusion: Prenatal diagnosis of meconium peritonitis is associated with higher surgical di culty, longer hospital stay and delayed intestinal function recovery. However, there is no evidence of higher mortality rates or more complications compared to infants diagnosed postnatally, and there is no signi cant difference in long-term prognosis.

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Section: Postoperative Indicatorsmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Does prenatal diagnosis of meconium peritonitis have the better recovery? A single-center over 10 years of experience

Li,

Lu,

Wang

et al. 2024

Pediatr Surg Int

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“…Common underlying pathologies include causes of congenital intestinal obstruction, such as small bowel atresia, midgut volvulus, Hirschsprung's disease etc. ( 5 ). Meconium ileus (MI) may be associated with IA and MP, which can be an early manifestation of cystic fibrosis (CF).…”

Section: Discussionmentioning

confidence: 99%

“…Meconium ileus (MI) may be associated with IA and MP, which can be an early manifestation of cystic fibrosis (CF). CF is an autosomal recessive disease common in Caucasians, but nearly absent in Asians, which affects the respiratory tract, pancreas, gut, and hepatobiliary tract ( 5 , 6 ). CF should also be considered in infants that present with white stool, especially if combined with anemia and hypoproteinemia ( 7 ).…”

Section: Discussionmentioning

confidence: 99%

Meconium Peritonitis, Intestinal Atresia Combined With Biliary Atresia: A Case Report

Han

Chen

et al. 2022

Front. Pediatr.

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Meconium peritonitis (MP) combined with intestinal atresia (IA) is a rare neonatal condition, and it is even rarer in combination with biliary atresia (BA). We describe a case of an infant who developed short bowel syndrome after partial intestinal resection due to MP and IA, along with a Santullienterostomy. During continuous enteral and parenteral nutrition, the stool color became paler. BA was identified by elevated direct bilirubin (DBIL), gamma-glutamyltransferase (GGT), serum matrix metalloproteinase-7 (MMP-7), and hepatobiliary ultrasound; then, Kasai portoenterostomy (KPE) was performed promptly. The Roux-en-Y limb was adjusted intraoperatively to preserve the maximum length of the small intestine while closing the enterostomy. After the operation, the infant gradually adapted to enteral nutrition, his bilirubin level returned to normal, and his weight gradually caught up to the normal range. Although rare, BA should be suspected when MP is combined with IA and when the stool becomes paler in color in the enterostomy state.

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“…The feces entering the abdominal cavity not only greatly increases the chance of infection, but also results in intestinal damage and paralysis, both of which are not conducive to the recovery of the intestinal function. Under the circumstances, many surgeons give priority to enterostomy in the case of possible serious infection ( 11 , 12 ). Furthermore, the interruption of intestinal continuity makes the distal intestinal tract smaller because of long-term disuse atrophy, while the proximal intestinal tract expands passively due to obstruction.…”

Section: Discussionmentioning

confidence: 99%

The multivariate cox regression model for complete enteral nutrition after primary anastomosis in neonates with intestinal atresia

et al. 2022

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ObjectiveEnteral feeding after intestinal atresia has always been a concern for clinicians. But the present studies mainly focused on single factors. This research aimed to comprehensively analyze the multiple factors on complete enteral nutrition after primary anastomosis, and establish the convenient prediction model.MethodsWe retrospectively collected reliable information in neonates with intestinal atresia form January 2010 to June 2022. The cox regression analysis was performed to select independent risk factors and develop nomogram. Subsequently, ROC curve, calibration curve and decision curve were drawn to thoroughly evaluate the accuracy and applicability of the model.ResultsThe predictors finally included in the model were gestational age, meconium peritonitis, distance from the anastomosis to the ileocecal region, diameter ratio of proximal to distal bowels, and time of initial feeding. The nomogram of predicting the probability of week 2, week 3 and week 4 was drawn and their area under the curve were 0.765, 0.785 and 0.747, respectively. Similarly, calibration and decision curve indicated that the prediction model had a great prediction performance.ConclusionThe clinical value of predictive models can be recognized. The hope is that the predictive model can help pediatricians reduce hospital costs and parental anxiety.

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Meconium peritonitis: A 22-year review in a tertiary referral center

Cited by 6 publications

References 19 publications

Does prenatal diagnosis of meconium peritonitis have the better recovery? A single-center over 10 years of experience

Does prenatal diagnosis of meconium peritonitis have the better recovery? A single-center over 10 years of experience

Meconium Peritonitis, Intestinal Atresia Combined With Biliary Atresia: A Case Report

The multivariate cox regression model for complete enteral nutrition after primary anastomosis in neonates with intestinal atresia

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