Presentation
31-week gestation infant with feeding intolerance and increased abdominal girth. Evaluate for necrotizing enterocolitis.
Patient Data
There are multiple, tubular-appearing dilated loops of bowel in the right abdomen as well as additional mild to moderately dilated loops in the left abdomen. No air is present at the level of the rectum.
An umbilical venous catheter with tip below the level of the ductus venosus and an NG tube is advanced to the stomach.
There was free flow of contrast from the rectosigmoid colon to the cecum with reflux into the
terminal ileum and likely the appendix. The terminal ileum tapers, therefore an ileal atresia/stenosis is suspected. There are several few scattered lucent defects, consistent with retained meconium. The overall caliber of the colon is slightly small.
There is an OG-tube with its tip in the region of the gastric body.
Case Discussion
This is a case of ileal atresia as seen on fluoroscopy and abdominal radiograph. The patient was taken to the operating room for an exploratory laparotomy, excision of necrotic ileum, and an ileostomy. The patient did well post-operatively and the ileostomy was eventually taken down.
Co-author:
Travis Bevington, MD
Unable to process the form. Check for errors and try again.