Diminishing role of contrast enema in simple meconium ileus.
OBJECTIVE
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 chi(2) 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.
Copeland
Daniel R
DR
Arkansas Children's Hospital, Little Rock, AR 72202-3591, USA.
St Peter
Shawn D
SD
Sharp
Susan W
SW
Islam
Saleem
S
Cuenca
Alex
A
Tolleson
Joshua S
JS
Dassinger
Melvin S
MS
Little
Danny C
DC
Jackson
Richard J
RJ
Kokoska
Evan R
ER
Smith
Samuel D
SD
D001724:Birth Weight; D003550:Cystic Fibrosis / Q000150:complications* / Q000601:surgery; D003974:Diatrizoate Meglumine; D004733:Enema / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D045823:Ileus / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D008470:Meconium / Q000000981:diagnostic imaging*; D011300:Preoperative Care / Q000379:methods; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
D003974:Diatrizoate Meglumine