Meconium ileus (neonate with cystic fibrosis)

Case contributed by Dr Michael Sargent

Presentation

Failure to pass meconium.

Patient Data

Age: Neonate
Modality: X-ray

Dilated loops of bowel are present. 

Modality: Fluoroscopy

Following the Upper GI, contrast enema was performed. Initially, 50/50 dilution of Omnipaque 300 was introduced as far as the terminal ileum. This was followed by repeat enema after an interval of about 15 minutes, this time using 50/50 Omnipaque with 10% dilution of acetylcysteine solution.

The rectum and distal sigmoid show normal appearances. Meconium was encountered at the mid proximal sigmoid and identified all the way around to the splenic flexure. The transverse colon appeared clear.

There was no evidence of microcolon. Contrast advanced into the terminal ileum did demonstrate further retained meconium. A number of large meconium plugs were evacuated from the colon with the assistance of suction via the Foley catheter. However, at the end of the procedure, the last removed plug which may have come from the distal ileum as was pale in colour.

Case Discussion

Neonate with a meconium ileus and cystic fibrosis

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Case Information

rID: 6009
Case created: 6th Apr 2009
Last edited: 7th May 2016
Inclusion in quiz mode: Included

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