European Paediatric Surgeons' Association Consensus Statement on the Management of Meconium Ileus.

IF 1.8 3区医学 Q2 PEDIATRICS

European Journal of Pediatric Surgery Pub Date : 2026-10-01 Epub Date: 2026-06-29 DOI:10.1055/a-2891-7849

Amulya K Saxena, Romilly K Hayward, Annika Mutanen, Naziha Khen-Dunlop, Hilmican Ulman, Richard Keijzer, Louise Montalva, Bethan Johnson, Stuart Hosie, Adinda Pijpers, Ramon Gorter

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引用次数: 0

Abstract

Introduction: The management of meconium ileus (MI) has yet to reach a unified consensus among pediatric surgeons, particularly regarding diagnostics and variants, conservative treatment strategies, surgical approaches, and clinical outcomes. This topic was therefore selected for the 2024 Consensus Session of the Annual Congress European Paediatric Surgeons' Association (EUPSA).

Methods: A structured literature review was conducted across Cochrane, Medline, and EMBASE databases up to April 2024. Nine pediatric surgeons appointed by the European Paediatric Surgeons' Association (EUPSA) Consensus Committee reviewed the evidence and developed topic-specific recommendations relating to (1) diagnostics and variants, (2) Gastrografin® (Bracco Diagnostics Inc, Monroe Township, NJ) application and outcomes, and (3) surgery-related outcomes. Findings were presented at the 2024 EUPSA Annual Congress, with consensus statements formulated through iterative discussion and refinement, incorporating feedback from congress participants.

Results: The consensus addresses antenatal and postnatal diagnosis, differentiation between simple and complex MI, conservative management using contrast enemas, surgical strategies, and short- and long-term outcomes, particularly in relation to cystic fibrosis (CF). Key recommendations include the use of contrast enema as the primary diagnostic modality and first-line treatment in uncomplicated cases, with surgical intervention indicated for complicated MI or failed conservative management. Enterostomy remains a widely used surgical approach, with technique guided by intraoperative findings and patient factors. Recommendations regarding stoma reversal emphasize the role of multidisciplinary assessment and preoperative evaluation including CF workup and confirmation of distal bowel patency.

Conclusion: A peer-reviewed consensus statement on the diagnosis and management of MI has been developed, informed by current evidence and expert practice. This statement provides pragmatic guidance in the diagnosis and management of MI, including the role of contrast enema in uncomplicated cases and surgical intervention for complicated disease. It is recognized by the EUPSA as a valuable resource to support pediatric surgeons in clinical decision-making for this pathology.

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欧洲儿科外科医师协会关于胎便性肠梗阻处理的共识声明。

导言：胎便性肠梗阻（MI）的治疗尚未在儿科外科医生中达成统一的共识，特别是关于诊断和变异、保守治疗策略、手术方法和临床结果。因此，该主题被选为欧洲儿科外科医师协会（EUPSA）年度大会2024年共识会议。方法：对截至2024年4月的Cochrane、Medline和EMBASE数据库进行结构化文献综述。由欧洲儿科外科医生协会（EUPSA）共识委员会任命的九名儿科外科医生审查了证据并制定了关于(1)诊断和变异，(2)Gastrografin®（Bracco diagnostics Inc, Monroe Township， NJ）应用和结果的特定主题建议，以及(3)手术相关结果。研究结果在2024年EUPSA年会上公布，并通过反复讨论和改进，结合大会参与者的反馈，制定了共识声明。结果：共识涉及产前和产后诊断、单纯性和复合性心肌梗死的区分、使用对比灌肠的保守治疗、手术策略以及短期和长期结果，特别是与囊性纤维化（CF）相关的结果。主要建议包括使用造影剂灌肠作为主要诊断方式，在无并发症的病例中使用一线治疗，对于复杂的心肌梗死或保守治疗失败需要手术干预。肠造口术仍然是一种广泛使用的手术方法，其技术取决于术中发现和患者因素。关于造口翻转的建议强调多学科评估和术前评估的作用，包括CF检查和远端肠通畅的确认。结论：根据目前的证据和专家实践，已经制定了一份关于心肌梗死诊断和管理的同行评议共识声明。这一声明为心肌梗死的诊断和治疗提供了实用的指导，包括在无并发症病例中造影剂灌肠的作用和对复杂疾病的手术干预。它被EUPSA认可为一个宝贵的资源，以支持儿科外科医生对这种病理的临床决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pediatric Surgery 医学-外科

CiteScore

3.90

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This broad-based international journal updates you on vital developments in pediatric surgery through original articles, abstracts of the literature, and meeting announcements. You will find state-of-the-art information on: abdominal and thoracic surgery neurosurgery urology gynecology oncology orthopaedics traumatology anesthesiology child pathology embryology morphology Written by surgeons, physicians, anesthesiologists, radiologists, and others involved in the surgical care of neonates, infants, and children, the EJPS is an indispensable resource for all specialists.