Meconium ileus: laparotomy without resection, anastomosis, or enterostomy.

During the 14 yr from 1965 through 1978, 49 infants presented shortly 
after birth with intestinal obstruction due to impacted meconium. Three of 
these patients did not have fibrocystic disease. Eight patients were cured 
by a Gastrografin enema. There were 18 patients who had complications 
that included associated atresia, volvulus, and/or peritonitis. Various operations were done 
including resection with either primary anastomosis or enterostomy or varieties of 
the foregoing. Twenty-three babies had the simple uncomplicated form of meconium 
ileus. Eleven of these underwent resection and six patients died. Twelve 
patients were treated by laparotomy, ileotomy through a purse-string suture and 
prolonged irrigations using acetylcysteine. Of this group only one succumbed. This 
latter course of management is recommended for patients with simple uncomplicated 
meconium ileus as it involves no resection, no enterostomy, nor any 
primary anastomosis. 