INSPISSATED MECONIUM SYNDROME ― NEONATAL MECONIUM OBSTRUCTION IN THE ILEUM WITHOUT MUCOVISCIDOSIS ―
We experienced of five newborns with obstruction of terminal ileum or ascending colon due to very tenacious black-green meconium in the absence of mucoviscidosis. These disorders differ from meconium plug syndrome, meconium ileus and paralytic ileus in the following criteria: 1) All the infants vomited bile-stained material. 2) They passed normal meconium just after birth, which was followed by tenacious black-green meconium. 3) The intestinal sounds were noticed over the abdomen. 4) The fluid levels were seen in the upright plain film. 5) The colon had normal peristalsis at GastrografinR enema. 6) There was no recurrence after obstruction being released. Therefore, we prefer to distinguish this disease from meconium plug syndrome, meconium ileus and paralytic ileus and call it "Inspissated Meconium Syndrome". We believe that this obstruction was caused by a large amount of PAS-positive mucus, secretion from the obstructed intestinal mucosa. In this paper, we describe on four clinical cases and one autopsy case of this particular type. Intestinal obstruction in the neonate may result from a variety of causes. A few kinds of neonatal intestinal obstruction, such as meconium ileus and meconium plug syndrome are caused by abnormal meconium. Rarer forms of meconium obstruction, however, may be due to other conditions. In our hospital, 10,534 newborn infants have been examined during the past six years. There were twenty-one cases of neonatal intestinal obstruction due to causes other than paralytic ileus among them. The cases included seven anorectal malformations, three intestinal atresias, two omphaloceles, two meconium plug syndromes, one aganglionosis, one malrotation and five special types of intestinal obstruction. These special types consisted of obstruction of the terminal ileum or ascending colon by a pack of very tenacious black-green meconium which occurred in the absence of mucoviscidosis.