Confronted by a case of meconium ileus with complicating meconium peritonitis, one of us (T. D. T.) side-tracked the obstruction by means of an ileocolostomy and provided immediate decompression with a proximal Witzel ileostomy. The results were satisfactory enough to warrant the application of this technique to a subsequent uncomplicated case of meconium ileus, and these experiences form the basis of this report.
Meconium ileus is a mechanical obstruction of the bowel noted usually during the first 48 hours of life and caused by the presence of an abnormally thick, exceedingly tenacious meconium in the terminal ileum. This condition was described by Landsteiner1 (1905), and a relationship to fibrocystic disease of the pancreas was established by him. The preponderance of subsequent thought was that the absence of pancreatic secretion from the intestine prevented digestion and liquefaction of the meconium and allowed its inspissation in the terminal ileum.