Abstract
Abdominal plain films of 133 neonates, with 82 cases of meconium plug syndrome (MPS), 27 cases of meconium ileus (MI) and 24 cases of neonatal Hirschsprung's disease (HD), were reviewed to assess the value of such radiographs for diagnosis. The radiographs were examined according to a list of 11 parameters. By using multivariate discriminant analysis, it appeared that 4 parameters i.e. dilatation of bowel loops, varying loop calibre, fluid levels and colonic gas were most important in discriminating among the three disorders. For each parameter the weight (in points) was derived. To classify patients, three group-scores had to be calculated: the group-score with the largest value indicated the most likely disorder. So in 99%, 88% and 63% of MPS, HD and MI, respectively, an accurate diagnosis could be predicted. The overall diagnostic accuracy was 89%. Such a diagnosis can be a sound basis for further investigation.
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References
Holsclaw DS, Eckstein HB, Nixon HH (1965) Meconium ileus. A 20-year review of 109 cases. Am J Dis Child 109: 101
Dolan TF Jr, Touloukian RJ (1974) Familial meconium ileus not associated with cystic fibrosis. J Pediatr Surg 9: 821
Shigemoto H, Endo S, Isomoto T, Sano K, Taguchi K (1978) Neonatal meconium obstruction in the ileum without mucoviscoidosis. J Pediatr Surg 13: 475
Pochaczevsky R, Leonidas JC (1974) The meconium plug syndrome. Roentgen evaluation and differentiation from Hirschsprung's disease and other pathologic states. AJR Radium Ther Nucl Med 120: 342
Schey WL, White H (1971) Hirschsprung's disease. Problems in the roentgen interpretation. AJR Radium Ther Nucl Med 112: 105
Leonidas JC, Berdon WE, Baker DH, Santulli TV (1970) Meconium ileus and its complications. A reappraisal of plain film roentgen diagnostic criteria. AJR Radium Ther Nucl Med 108: 598
Caffey J (1985) Pediatric X-ray diagnosis, 8th edn. Year Book Medical Publishers, Chicago, pp 1838–1858
Tucker AS, Izant RJ Jr (1971) Problems with meconium. AJR Radium Ther Nucl Med 112: 135
Davis WS, Allen RP, Favara BE, Slovis TL (1974) Neonatal small left colon syndrome. AJR Radium Ther Nucl Med 120: 322
LeQuesne GW, Reilly BJ (1975) Functional immaturity of the large bowel in the newborn infant. Radiol Clin North Am 13: 33
Berdon WE, Slovis TL, Campbell JB, Baker DH, Haller JO (1977) Neonatal small left colon syndrome: its relationship to aganglionosis and meconium plug syndrome. Radiology 125: 457
Swischuk LE (1989) Radiology of the newborn, infant, and young child. 3rd edn. William and Wilkins, pp 436–446 and pp 474–487
Eklöf O (1977) Current concepts in pediatric radiology. Springer, Berlin Heidelberg New York, pp 54–58
Clatworthy HW Jr, Howard WHR, Lloyd J (1956) The meconium plug syndrome. Surgery 39: 131
Bill AH, Chapman ND (1962) The enterocolitis of Hirschsprung's disease. Its natural history and treatment. Am J Surg 103: 70
Caniano DA, Beaver BL (1987) Meconium ileus: a fifteen-year experience with forty-two neonates. Surgery 102: 699
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Hussain, S.M., Meradji, M., Robben, S.G.F. et al. Plain film diagnosis in meconium plug syndrome, meconium ileus and neonatal Hirschsprung's disease. Pediatr Radiol 21, 556–559 (1991). https://doi.org/10.1007/BF02012596
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DOI: https://doi.org/10.1007/BF02012596