A new nonoperative treatment for uncomplicated meconium ileus has recently been described. Obstruction is relieved by high gastrografin enema. In View of the high surgical mortality for meconiuun ileus, this procedure appears to be a valuable contribution. Gastrografin has an osmolality of 1900 mOsm/L and when introduced into the gastrointestinal tract has been reported to decrease plasma volume. This may be dangerous to the sick infant. The purpose of this study is to identify the alterations that occur with gastrografin and to suggest preventive measures. Twenty newborn puppies received either a high gastrografin or barium enema. Castrografin produced an increase in hematocrit, a rising serum osmolality, and a fall in pulse rate and cardiac output. It is suggested that the physician, before he embarks on the non-operative treatment of meconium ileus, should be aware of the dangers and correct pre-existing dehydration, increase the intravenous fluid intake during the enema, and have a means of monitoring water balance. Four patients managed in this fashion, showed no changes in their clinical condition or serial serum osmolality measurements.
Meconium Ileus Equivalent Complicating Cystic Fibrosis in Postneonatal Children and Young Adults