Discussion of Meconium ileus
- 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.
- Usually a manifestation of cystic fibrosis. Usually understood as synonymous with cystic fibrosis until proven otherwise.
- Approximately 20% of infants with cystic fibrosis present with meconium ileus at birth.
- May also be seen with pancreatic atresia or stenosis of the pancreatic duct.
- 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.
- More common in white populations.
- Affects both sexes almost equally.
 Imaging Findings for Meconium ileus
- 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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 References for Meconium ileus
- Denholm, T.A., Crow, H.C., Edwards, W.H., Simmons, G.M., Marin-Padilla, M., and Bartrum, R.J. Prenatal sonographic appearance of meconium ileus in twins. AJR, 1984; 143: 371-372.
- Leonidas, J.C., Berdon, W.E., Baker, D.H., and Santulli, T.V. Meconium ileus and its complications: a reappraisal of plain film roentgen diagnostic criteria. American Roentgen Ray Society, 1970.