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DOI: 10.1055/s-0030-1249038
© Georg Thieme Verlag KG Stuttgart · New York
Clinical Course of Obstructive Jaundice Associated with Operated Meconium Peritonitis in Neonates
Publikationsverlauf
received December 16, 2009
accepted after revision January 30, 2010
Publikationsdatum:
09. April 2010 (online)
![](https://www.thieme-connect.de/media/ejps/201004/lookinside/thumbnails/10.1055-s-0030-1249038-1.jpg)
Abstract
Background/Purpose: Meconium peritonitis (MP) may induce prolonged cholestasis after laparotomy. In this study, we investigated the postoperative clinical course of MP retrospectively and discuss the relationship between MP and the development of obstructive jaundice, including biliary atresia (BA).
Patients and Methods: Between 1979 and 2008, 23 infants with MP underwent laparotomy at our institution. Eleven of the 23 infants (47.8%) developed obstructive jaundice postoperatively. The medical charts of these 11 infants were reviewed.
Results: The causative disease underlying MP included jejunoileal atresia in 10 and cloacal anomaly in 1. Of these 11 infants, 4 had acholic stools. Nine of the 11 improved with conservative management including an expectant approach, choleretic agents, and exchange blood transfusion. To differentiate the diagnosis from BA, open cholangiography was required in 2 cases following negative HIDA scintigraphy and a small gallbladder on ultrasonography. One of these 2 cases was diagnosed as BA and underwent hepatic portoeneterostomy simultaneously, after which the infant became jaundice free.
Conclusions: Postoperative cholestasis after MP was a transient condition in most cases. However, ultrasonography and HIDA scintigraphy should be performed to differentiate BA in infants with MP who show prolonged jaundice with acholic stools.
Key words
meconium peritonitis - jaundice - biliary atresia - complication - cholestasis
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Correspondence
Dr. Shigehisa Fumino
Kyoto Prefectural University of Medicine
Department of Pediatric Surgery
465 Kajii-cho
Hirokoji
602-8566 Kyoto
Japan
Telefon: +81 75 251 5809
Fax: +81 75 251 5828
eMail: fumin@koto.kpu-m.ac.jp