Recent Change in Management Pattern of Meconium Ileus at Dhaka Shishu Hospital

Authors

  • Kazi Md Noor ul Ferdous Division of Pediatric Surgery, Bangladesh Institute of Child Health (BICH) & Dhaka Shishu Hospital, Dhaka
  • Md Samiul Hasan Division of Pediatric Surgery, Bangladesh Institute of Child Health (BICH) & Dhaka Shishu Hospital, Dhaka
  • Ashfaq Nabi Division of Pediatric Surgery, Bangladesh Institute of Child Health (BICH) & Dhaka Shishu Hospital, Dhaka
  • Md Arman Hossain Division of Pediatric Surgery, Bangladesh Institute of Child Health (BICH) & Dhaka Shishu Hospital, Dhaka
  • M Kabirul Islam Division of Pediatric Surgery, Bangladesh Institute of Child Health (BICH) & Dhaka Shishu Hospital, Dhaka
  • Tahmina Banu Department of Pediatric Surgery, Chittagong Research Institute for Children Sugary (CRICS), Chittagong

DOI:

https://doi.org/10.3329/cmoshmcj.v16i2.37284

Keywords:

Meconium ileus, Bishop Koop ileostomy, T tube ileostomy, Mikulicz procedure.

Abstract

Background : Meconium Ileus (MI) accounting for 9–33% of neonatal intestinal obstruction and one of the common cause of intestinal obstruction in neonate. Near about 50% can be present with various complications. Options for surgical management of MI include resection of dilated ileum with primary anastomosis, Bishop–Koop ileostomy, Santulli procedure or Mikulicz procedure and T tube ileostomy. In our center, before January 2015, mostly Mikulicz and few Bishop- Koop procedures were done for MI. But, the complications were high. From 2015, we started to perform T tube ileostomy and Bishop-Koop procedure in simple MI. In complicated cases Mikulicz and Bishop-Koop procedure were done and the scenario changed. This study was done to compare the outcome of MI surgery before and after January 2015.

Methods: This was a retrospective study done in our center during January 2011 to December, 2016 (5 years). All cases were divided into two groups (Group-A: January 2011 to December 2014 and in Group-B: January 2015 to December 2016). Demographic data and surgical outcomes were compared.

Results: Total 216 cases were included, in Group-A: 123 patients and others were in Group- B. Simple MI were 49% in Group-A and 56% were in Group-B. Complicated MI presented with small gut volvulus (43.3%) gangrene of loaded ileum (32.2%) perforation with peritonitis (37.8%) intestinal atresia with adhesions (16.3%) and meconium pseudocysts in 12 cases (16%). 11 patients had more than one complication. All the postoperative complications were found significantly high in Group-A except anastomotic leakage. Mortality was also significantly high in Group-A.

Conclusion: Morbidity and mortality were significantly reduced with increasing practice of T tube ileostomy and Bishop-Koop procedure in simple and complicated Meconium ileus.

Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 5-8

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Published

2018-07-03

How to Cite

Ferdous, K. M. N. ul, Hasan, M. S., Nabi, A., Hossain, M. A., Islam, M. K., & Banu, T. (2018). Recent Change in Management Pattern of Meconium Ileus at Dhaka Shishu Hospital. Chattagram Maa-O-Shishu Hospital Medical College Journal, 16(2), 5–8. https://doi.org/10.3329/cmoshmcj.v16i2.37284

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Original Articles