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Meconium ileus and intestinal atresia in fetuses and neonates.

A collaborative study was performed to determine the different types and mechanisms of intestinal abnormalities during gestation. Cases had to fulfill one or more of the following three criteria: (1) meconium ileus, (2) intestinal stenosis or atresia, and (3) meconium peritonitis. Esophageal atresia, anorectal atresia, and abdominal wall defects were excluded. One hundred two cases were reviewed from the autopsies of 42 induced abortions, 22 stillborns, and the surgical findings in 38 neonates. Meconium ileus was detected mainly during the second trimester (28/38), and was associated with cystic fibrosis (15), fetal blood deglutition (4), infection (6), or multiple-abnormalities (10), in which three chromosomal aberrations were found. Intestinal stenosis or atresia was more commonly detected during the third trimester of gestation (46/56). Sixteen of the 30 duodenal malformations were associated with trisomy 21, whereas in the 26 small intestinal atresias, signs of distress or ischemia were most frequently detected. Only 8 of 25 meconium peritonitis cases were isolated. A total of 20 cystic fibrosis cases could be proved. In this series, functional abnormalities were observed predominantly in the second trimester and associated mainly with cystic fibrosis or amniotic fluid abnormalities. Anatomic lesions were commonly detected later on and associated with ischemic conditions, chromosomal aberrations, and even cystic fibrosis.

Constriction, Pathologic↗
PubMed1981

[Long-term results in intestinal atresias and stenoses distal to the ligament of Treitz (author's transl)].

From 1945 to 1975 61 cases of atresias and stenoses of the small intestine distal to the ligament of Treitz and atresias and stenoses of the colon were treated at the University Children's Hospital Zurich. The long-term results of 51 well documented cases are presented and the influence of improvement of operative techniques the establishment of an intensive care unit and the introduction of long-term parenteral nutrition is analyzed. Cases treated during the earlier period (1945-1965) are compared with those from 1966 to 1975. The overall-all mortality was high. Out of 51 patients there were only 19 long-term survivors. During the first period 71% died, during the second 52%. The reason for the still high mortality is especially the high number of intraoperative additional complicating findings (meconium peritonitis, volvulus etc.). Additional malformations in other organ systems and low birth weight were not important factors for survival in this series. None of the 19 long-term survivors had to be reoperated after the first discharge from the hospital. At late control they were healthy, and most of them without abdominal symptoms. Only three complained of occasional diarrhoea. All but one were within normal percentiles for weight and height.

Adolescent↗