{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T14:44:06Z","timestamp":1792075446482,"version":"4.4.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Meconium\u2010related ileus (MRI) often mimics other surgical pathologies in extremely low birth weight infants (ELBWIs), leading to diagnostic difficulties. This study aimed to clarify the clinical presentation and management outcomes of enema therapy in ELBWIs with a specific focus on the clinical indicators of underlying non\u2010MRI surgical pathologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective review was conducted of 31 ELBWIs (birth weight\u2009&lt;\u20091000\u2009g) who received enema therapy for suspected MRI at a single tertiary center between 2008 and 2024. Infants were categorized into Success (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920) and Failure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911) groups. The clinical characteristics, timing of intervention, and underlying pathologies were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Underlying non\u2010MRI surgical pathologies were identified only in the Failure group (36% [4\/11] vs. 0% [0\/20] in the Success group,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), including Hirschsprung disease, necrotizing enterocolitis, meconium peritonitis, and ileal stenosis. The overall survival was significantly lower in the Failure group than in the Success group (55% vs. 95%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013). A descriptive review of these non\u2010MRI patients highlighted that an atypically late initial enema therapy or a high frequency of repetitive procedures was critical clinical features that masked the underlying pathologies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In ELBWIs with suspected MRI, the failure of enema therapy was significantly associated with underlying non\u2010MRI surgical pathologies. Although these findings require validation in larger cohorts, delayed initiation of therapeutic enema or repeated procedures without sustained improvement should prompt reassessment for non\u2010MRI surgical pathology and early surgical consultation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70549","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T07:35:51Z","timestamp":1787297751000},"page":"1981-1986","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Pitfalls in Meconium\u2010Related Ileus: Red Flags for Surgical Pathologies in Extremely Low Birth Weight Infants"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6033-7946","authenticated-orcid":false,"given":"Kenji","family":"Santo","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery Osaka City General Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Takama","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Osaka City General Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Todo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Osaka City General Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Neonatology Osaka City General Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Ichiba","sequence":"additional","affiliation":[{"name":"Department of Neonatology Osaka City General Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Kamiyama","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Osaka City General Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9245-7854","authenticated-orcid":false,"given":"Takashi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Osaka City General Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1072290"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2024.161935"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.15493"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.12815"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-016-3985-z"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-017-4129-9"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2015.06.006"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0272915"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-025-06151-2"},{"key":"e_1_2_13_11_1","article-title":"Meconium\u2010Related Obstruction: Contemporary Experience in a Multi\u2010Institutional Consortium","volume":"13","author":"Rook J. M.","year":"2025","journal-title":"Journal of Pediatric Surgery"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372\u2010025\u201002395\u2010x"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-013-0824-x"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pedneo.2024.11.007"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2021.03.029"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-009-2334-x"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-007-1984-9"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70549","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.70549","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.70549","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T13:44:41Z","timestamp":1792071881000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.70549"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/jpc.70549"],"URL":"https:\/\/doi.org\/10.1111\/jpc.70549","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"value":"1034-4810","type":"print"},{"value":"1440-1754","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"assertion":[{"value":"2026-07-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}