Management of extremely low birth weight neonates with bowel obstruction within 2 weeks after birth
Purpose The majority of bowel obstructions in extremely low birth weight (ELBW) neonates are meconium-related ileus (MRI). ELBW neonates with bowel obstruction may recover by conservative treatment, but some do not. Considering the high surgical morbidity rates, unnecessary surgery should be avoided...
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| Veröffentlicht in: | Surgery today (Tokyo, Japan) Japan), 2014-12, Vol.44 (12), p.2269-2274 |
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| creator | Hatanaka, Akira Nakahara, Saori Takeyama, Eriko Iwanaka, Tadashi Ishida, Kazuo |
| description | Purpose
The majority of bowel obstructions in extremely low birth weight (ELBW) neonates are meconium-related ileus (MRI). ELBW neonates with bowel obstruction may recover by conservative treatment, but some do not. Considering the high surgical morbidity rates, unnecessary surgery should be avoided. We sought to identify a reasonable treatment strategy under these conditions.
Methods
ELBW neonates who started to have bowel obstruction with an unclear cause within 14 days of age were enrolled. The study period was from January 2009 to August 2011. The enrolled patients had daily Gastrografin
®
enemas until 14 days of age or until the obstruction resolved. If the obstruction lasted beyond around 14 days of age, the patient underwent surgical intervention. The clinical data of the patients were collected and analyzed.
Results
Fourteen patients were enrolled. Twelve patients had MRI, which resolved within 14 days without surgery. Two patients with persistent obstruction underwent surgery, and they were found to have Hirschsprung’s disease and ileal volvulus, respectively.
Conclusion
For ELBW neonates with bowel obstruction of unclear etiology, the early and frequent administration of a Gastrografin
®
enema is reasonable. Surgery should be considered if the obstruction lasts beyond approximately 14 days after birth. |
| doi_str_mv | 10.1007/s00595-013-0824-x |
| format | Article |
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The majority of bowel obstructions in extremely low birth weight (ELBW) neonates are meconium-related ileus (MRI). ELBW neonates with bowel obstruction may recover by conservative treatment, but some do not. Considering the high surgical morbidity rates, unnecessary surgery should be avoided. We sought to identify a reasonable treatment strategy under these conditions.
Methods
ELBW neonates who started to have bowel obstruction with an unclear cause within 14 days of age were enrolled. The study period was from January 2009 to August 2011. The enrolled patients had daily Gastrografin
®
enemas until 14 days of age or until the obstruction resolved. If the obstruction lasted beyond around 14 days of age, the patient underwent surgical intervention. The clinical data of the patients were collected and analyzed.
Results
Fourteen patients were enrolled. Twelve patients had MRI, which resolved within 14 days without surgery. Two patients with persistent obstruction underwent surgery, and they were found to have Hirschsprung’s disease and ileal volvulus, respectively.
Conclusion
For ELBW neonates with bowel obstruction of unclear etiology, the early and frequent administration of a Gastrografin
®
enema is reasonable. Surgery should be considered if the obstruction lasts beyond approximately 14 days after birth.</description><identifier>ISSN: 0941-1291</identifier><identifier>EISSN: 1436-2813</identifier><identifier>DOI: 10.1007/s00595-013-0824-x</identifier><identifier>PMID: 24407284</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Age Factors ; Diatrizoate Meglumine - administration & dosage ; Digestive System Surgical Procedures - methods ; Enema ; Female ; Hirschsprung Disease - therapy ; Humans ; Ileus - etiology ; Ileus - therapy ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Male ; Meconium ; Medicine ; Medicine & Public Health ; Original Article ; Surgery ; Surgical Oncology ; Treatment Outcome</subject><ispartof>Surgery today (Tokyo, Japan), 2014-12, Vol.44 (12), p.2269-2274</ispartof><rights>Springer Japan 2014</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-6eac89d6e1a589dafef638169e84204e07f1a477f71f1507ca264057c0e8200b3</citedby><cites>FETCH-LOGICAL-c438t-6eac89d6e1a589dafef638169e84204e07f1a477f71f1507ca264057c0e8200b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00595-013-0824-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00595-013-0824-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,27929,27930,41493,42562,51324</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24407284$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hatanaka, Akira</creatorcontrib><creatorcontrib>Nakahara, Saori</creatorcontrib><creatorcontrib>Takeyama, Eriko</creatorcontrib><creatorcontrib>Iwanaka, Tadashi</creatorcontrib><creatorcontrib>Ishida, Kazuo</creatorcontrib><title>Management of extremely low birth weight neonates with bowel obstruction within 2 weeks after birth</title><title>Surgery today (Tokyo, Japan)</title><addtitle>Surg Today</addtitle><addtitle>Surg Today</addtitle><description>Purpose
The majority of bowel obstructions in extremely low birth weight (ELBW) neonates are meconium-related ileus (MRI). ELBW neonates with bowel obstruction may recover by conservative treatment, but some do not. Considering the high surgical morbidity rates, unnecessary surgery should be avoided. We sought to identify a reasonable treatment strategy under these conditions.
Methods
ELBW neonates who started to have bowel obstruction with an unclear cause within 14 days of age were enrolled. The study period was from January 2009 to August 2011. The enrolled patients had daily Gastrografin
®
enemas until 14 days of age or until the obstruction resolved. If the obstruction lasted beyond around 14 days of age, the patient underwent surgical intervention. The clinical data of the patients were collected and analyzed.
Results
Fourteen patients were enrolled. Twelve patients had MRI, which resolved within 14 days without surgery. Two patients with persistent obstruction underwent surgery, and they were found to have Hirschsprung’s disease and ileal volvulus, respectively.
Conclusion
For ELBW neonates with bowel obstruction of unclear etiology, the early and frequent administration of a Gastrografin
®
enema is reasonable. Surgery should be considered if the obstruction lasts beyond approximately 14 days after birth.</description><subject>Age Factors</subject><subject>Diatrizoate Meglumine - administration & dosage</subject><subject>Digestive System Surgical Procedures - methods</subject><subject>Enema</subject><subject>Female</subject><subject>Hirschsprung Disease - therapy</subject><subject>Humans</subject><subject>Ileus - etiology</subject><subject>Ileus - therapy</subject><subject>Infant, Extremely Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Meconium</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Treatment Outcome</subject><issn>0941-1291</issn><issn>1436-2813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1OwzAQhS0EoqVwADbISzaBseMkzhIh_iQQG1hbTjougTQutqO0t-EsnAxDCktWTzPz5mnmI-SYwRkDKM49QFZmCbA0AclFst4hUybSPOGSpbtkCqVgCeMlm5AD718BuJAA-2TChYCCSzEl8wfd6QUusQvUGorr4GLRbmhrB1o1LrzQAZvFS6Ad2k4H9HRoYrOyA7bUVj64vg6N7X7aTUf558eA-OapNgHdGHFI9oxuPR5tdUaer6-eLm-T-8ebu8uL-6QWqQxJjrqW5TxHprOo2qDJU8nyEqXgIBAKw7QoClMwwzIoas1zAVlRA0oOUKUzcjrmrpx979EHtWx8jW2r4_G9VyznWSryMuPRykZr7az3Do1auWap3UYxUN9w1QhXRbjqG65ax52TbXxfLXH-t_FLMxr4aPBx1C3QqVfbuy6-_E_qF50Whvo</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Hatanaka, Akira</creator><creator>Nakahara, Saori</creator><creator>Takeyama, Eriko</creator><creator>Iwanaka, Tadashi</creator><creator>Ishida, Kazuo</creator><general>Springer Japan</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20141201</creationdate><title>Management of extremely low birth weight neonates with bowel obstruction within 2 weeks after birth</title><author>Hatanaka, Akira ; Nakahara, Saori ; Takeyama, Eriko ; Iwanaka, Tadashi ; Ishida, Kazuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-6eac89d6e1a589dafef638169e84204e07f1a477f71f1507ca264057c0e8200b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Age Factors</topic><topic>Diatrizoate Meglumine - administration & dosage</topic><topic>Digestive System Surgical Procedures - methods</topic><topic>Enema</topic><topic>Female</topic><topic>Hirschsprung Disease - therapy</topic><topic>Humans</topic><topic>Ileus - etiology</topic><topic>Ileus - therapy</topic><topic>Infant, Extremely Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Meconium</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hatanaka, Akira</creatorcontrib><creatorcontrib>Nakahara, Saori</creatorcontrib><creatorcontrib>Takeyama, Eriko</creatorcontrib><creatorcontrib>Iwanaka, Tadashi</creatorcontrib><creatorcontrib>Ishida, Kazuo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery today (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hatanaka, Akira</au><au>Nakahara, Saori</au><au>Takeyama, Eriko</au><au>Iwanaka, Tadashi</au><au>Ishida, Kazuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of extremely low birth weight neonates with bowel obstruction within 2 weeks after birth</atitle><jtitle>Surgery today (Tokyo, Japan)</jtitle><stitle>Surg Today</stitle><addtitle>Surg Today</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>44</volume><issue>12</issue><spage>2269</spage><epage>2274</epage><pages>2269-2274</pages><issn>0941-1291</issn><eissn>1436-2813</eissn><abstract>Purpose
The majority of bowel obstructions in extremely low birth weight (ELBW) neonates are meconium-related ileus (MRI). ELBW neonates with bowel obstruction may recover by conservative treatment, but some do not. Considering the high surgical morbidity rates, unnecessary surgery should be avoided. We sought to identify a reasonable treatment strategy under these conditions.
Methods
ELBW neonates who started to have bowel obstruction with an unclear cause within 14 days of age were enrolled. The study period was from January 2009 to August 2011. The enrolled patients had daily Gastrografin
®
enemas until 14 days of age or until the obstruction resolved. If the obstruction lasted beyond around 14 days of age, the patient underwent surgical intervention. The clinical data of the patients were collected and analyzed.
Results
Fourteen patients were enrolled. Twelve patients had MRI, which resolved within 14 days without surgery. Two patients with persistent obstruction underwent surgery, and they were found to have Hirschsprung’s disease and ileal volvulus, respectively.
Conclusion
For ELBW neonates with bowel obstruction of unclear etiology, the early and frequent administration of a Gastrografin
®
enema is reasonable. Surgery should be considered if the obstruction lasts beyond approximately 14 days after birth.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>24407284</pmid><doi>10.1007/s00595-013-0824-x</doi><tpages>6</tpages></addata></record> |
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| ispartof | Surgery today (Tokyo, Japan), 2014-12, Vol.44 (12), p.2269-2274 |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Age Factors Diatrizoate Meglumine - administration & dosage Digestive System Surgical Procedures - methods Enema Female Hirschsprung Disease - therapy Humans Ileus - etiology Ileus - therapy Infant, Extremely Low Birth Weight Infant, Newborn Male Meconium Medicine Medicine & Public Health Original Article Surgery Surgical Oncology Treatment Outcome |
| title | Management of extremely low birth weight neonates with bowel obstruction within 2 weeks after birth |
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