Burge David, Drewett Melanie
Wessex Centre for Paediatric Surgery, G Level, East Wing, Southampton General Hospital, Tremona Road, SO16 6YD, Southampton, UK.
Pediatr Surg Int. 2004 Feb;20(2):108-10. doi: 10.1007/s00383-003-1098-y. Epub 2004 Feb 4.
We reviewed the final diagnosis and incidence of bowel pathology in neonates presenting with large bowel obstruction that was relieved by the passage of meconium plugs. A retrospective case-note review was undertaken of all patients with a discharge diagnosis of meconium plug syndrome (MPS), meconium ileus (MI), Hirschsprung's disease (HD), or small left colon syndrome (SLCS) from January 1996 to April 2002. Of 21 patients with meconium plug obstruction, eight (38%) had HD, nine had MPS, four had SLCS, and none had MI. However, there was considerable clinical and radiological overlap between MPS and SLCS, suggesting that these terms are imprecise. We found a much higher incidence of HD in babies presenting with meconium plug obstruction than has previously been reported. Overlap between MPS and SLCS suggests that these are not specific diagnoses and that current terminology needs to be changed. All babies with meconium plug obstruction should have HD and cystic fibrosis (CF) excluded.
我们回顾了因胎粪栓排出而缓解的新生儿大肠梗阻患者的最终诊断及肠道病理发生率。对1996年1月至2002年4月间出院诊断为胎粪栓综合征（MPS）、胎粪性肠梗阻（MI）、先天性巨结肠（HD）或小左结肠综合征（SLCS）的所有患者进行了回顾性病例记录审查。在21例胎粪栓梗阻患者中，8例（38%）患有HD，9例患有MPS，4例患有SLCS，无1例患有MI。然而，MPS和SLCS之间在临床和放射学上存在相当大的重叠，这表明这些术语并不精确。我们发现，与之前报道相比，出现胎粪栓梗阻的婴儿中HD的发生率要高得多。MPS和SLCS之间的重叠表明这些并非特异性诊断，当前的术语需要改变。所有患有胎粪栓梗阻的婴儿都应排除HD和囊性纤维化（CF）。
