T-TUBES IN THE MANAGEMENT OF MECONIUM ILEUS

Fifteen cases of meconium ileus (MI) were treated between 1986 and 199 5; 7 responded to conservative treatment. Eight were operated upon, an d comprise the study group. Six of the operated babies had no complica tions; 1 had meconium peritonitis with a pseudocyst and small-bowel at resia, and 1 had a volvulus of a small-bowel segment with necrosis. In all 8 cases a T-tube (TT) was left via an enterotomy; in the complica ted cases the enterotomy was pre-anastomotic. The obstruction was reli eved in all the babies, without any stoma or bowel resection in the un complicated cases. Two complications occurred: 1 patient died of respi ratory failure 1 month following surgery and another required a relapa rotomy for lysis of adhesions. We conclude that TT ileostomy is an eff ective and safe procedure for uncomplicated cases of MI that do not re spond to conservative therapy, as well as for complicated cases that n eed an anastomosis.