Virtual Pediatric Hospital: Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology: Case 48
Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
Michael P. D'Alessandro, M.D.,
Steven J. Fishman, M.D.,
Deborah E. Schofield, M.D.
Peer Review Status: Internally Peer Reviewed
Chief Complaint: Newborn full term female with a distended abdomen.
Clinical History: Newborn full term female who had a prenatal ultrasound that showed a thickened loop of bowel. An amniocentesis was performed and the fetus was diagnosed with cystic fibrosis. Upon delivery, the patient was noted to have a distended abdomen.
Clinical Physical Exam: Distended abdomen.
Clinical Labs: Non-contributory
Clinical Differential Diagnosis: Cystic fibrosis with meconium ileus.
Imaging Findings: Abdominal films from the first day of life showed a distal bowel obstruction. A water soluble contrast enema from the first day of life demonstrated a microcolon, and the terminal ileum could not be refluxed.
Operative Findings: The patient was managed non operatively.
Pathological Findings: None
Final Diagnosis: Meconium Ileus
Follow-up and Prognosis: The patient went on to have 3 therapeutic enemas, 2 with Cysto-Conray and the last with Gastrografin, over the next 48 hours. The terminal ileum was refluxed and the patient eventually passed all of the retained meconium.
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