Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Decreased exocrine gland function and lack of digestive enzymes lead to abnormally thick meconium which fills the terminal ileum and cannot be expelled. Fifty percent of cases are complicated by prenatal volvulus, ischemic necrosis, peritonitis, or intestinal atresia.
The classic abdominal film triad is ileal obstruction, a lack of air fluid levels because of the sticky meconium, and a "soap bubble" appearance to the right lower quadrant because of air bubbles mixed with the viscous intraluminal meconium. The enema usually demonstrates a microcolon, because it has never been used, and inspissated meconium throughout the colon and terminal ileum. It is treated by a hypertonic water soluble contrast enema that thoroughly refluxes the terminal ileum and reaches above the level of obstruction. The patient needs to be well hydrated before and after the enema. Several enemas may have to performed over several days to completely relieve the obstruction.
Low Bowel Obstruction
Section Top | Title Page
Follow us on Twitter @pedseducation and @pedsimaging
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2016 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.