Meconium ileus

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Meconium ileus

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Meconium found in the intestine of a newborn, consisting of succus entericus (bile salts, bile acids, and debris from the intestinal mucosa) Meconium is normally evacuated within 6 hours of birth or earlier. Meconium ileus occurs with meconium becomes inspissated and obstructs the distal ileum. It is usually a manifestation of cystic fibrosis. It is usually understood as synonymous with cystic fibrosis until proven otherwise. Approximately 20% of infants with cystic fibrosis present with meconium ileus at birth. It may also be seen with pancreatic atresia or stenosis of the pancreatic duct. It may rarely occur without cystic fibrosis or pancreatic abnormality in cases likely related to gut immaturity (more favorable outcome). Further complications include ileal atresia or stenosis, ileal perforation, meconium peritonitis, and volvulus with or without pseudocyst formation. It is more common in white populations. It affects both sexes almost equally.

Imaging Findings

  • Prenatal ultrasound findings associated with meconium ileus include polyhydramnios, fetal ascites, peritoneal wall calcifications, and intraabdominal cysts.
  • Meconium is normally invisible radiographically.
  • Occassionally, has a mottled appearance on radiographs during the first 2 days of life.
  • Classically, a paucity or absence of air-fluid levels and a "bubbly" appearance of distended intestinal loops on radiographs.
  • Microcolon seen on barium enema.
  • Characteristic findings often not seen, and thus relatively unreliable.

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