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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

Case 48

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.

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Imaging Differential Diagnosis:
Meconium ileus

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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Similar Cases:
Case 29, Case 46

References:

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