Willital G H, Meier H, Scranowitz P
Chirurg. 1977 Oct;48(10):657-62.
Meconium ileus is in most cases difficult to diagnose preoperatively; however, aganglionosis should be excluded in every case (rectal double-suction biopsy, manometry). In cases of uncomplicated meconium ileus (no perforation, no further intestinal obstructions) lysis of the meconium by a Gastrografin enema is tried first. In case of no relief, an intraoperative puncture of the bowel and Gastrografin instillation is performed. If there is no relief a small bowel resection is performed and a Bishop-Koop anastomosis or a chimney anastomosis established. A distinction must be made between meconium ileus, meconium disease, meconium plug syndrome, and curd obstruction. Results show a survival rate of 80%.
大多数情况下，胎粪性肠梗阻术前难以诊断；然而，每例均应排除无神经节症（直肠双吸活检、测压）。对于单纯性胎粪性肠梗阻（无穿孔、无进一步肠梗阻）病例，首先尝试用泛影葡胺灌肠溶解胎粪。若无效，则在术中穿刺肠管并注入泛影葡胺。若仍无效，则行小肠切除术并建立毕肖普-库普吻合术或烟囱式吻合术。必须区分胎粪性肠梗阻、胎粪病、胎粪堵塞综合征和凝块性肠梗阻。结果显示生存率为80%。
