Meconium Ileus

OVERVIEW

Meconium ileus refers to bowel obstruction that occurs due to the presence of thicker then normal meconium. This condition is most often seen in patients with cystic fibrosis.

Source
Source
WHAT MAKES US SUSPECT IT?

Risk factors

Cystic fibrosis

Initial Presentation: this condition will present in newborns

  • Vomiting (often bilious)
  • Failure to pass meconium

Physical Exam:

Abdominal Exam:

  • Distended firm abdomen

Rectal Exam:

  • Normal sphincter tone
  • Absence of stool in the rectal vault.
CLINICAL WORKUP

Contrast enema is the preferred modality used to diagnose meconium ileus. Findings can include a microcolon as well as a clear obstruction.

At top, a conventional radiograph of a newborn abdomen shows a "mass" in the right lower quadrant (white arrow) made up of loops of ileum with inspissated meconium, markedly dilated loops of bowel (black arrow) and a "soap-bubbly appearance to the meconium (white oval). In the contrast enema on the bottom, a small, unused microcolon (white arrows) is seen and there are filling defects representing meconium pellets in the terminal ileum and colon (black arrow). Case from learning radiology.com (source)
At top, a conventional radiograph of a newborn abdomen shows a “mass” in the right lower quadrant (white arrow) made up of loops of ileum with inspissated meconium, markedly dilated loops of bowel (black arrow) and a “soap-bubbly appearance to the meconium (white oval). In the contrast enema on the bottom, a small, unused microcolon (white arrows) is seen and there are filling defects representing meconium pellets in the terminal ileum and colon (black arrow). Case from learning radiology.com (source)
WHAT ELSE ARE WE WORRIED ABOUT?

Cystic fibrosis: while not all patients with cystic fibrosis will have a meconium ileus, almost all patients with meconium ileus will carry the diagnosis of cystic fibrosis.

ARCHIVE OF STANDARDIZED EXAM QUESTIONS 

This archive compiles standardized exam questions that relate to this topic.

 

Page Updated: 11.22.2016