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Correlapaedia - a Correlative Encyclopedia of Pediatric Imaging, Surgery, and Pathology
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.
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.
Similar Cases:
Case 29,
Case 46
References:
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