*Dept. of Paediatric Surgery, B J Wadia Hospital, Parel, Mumbai-400 012. Isolated Meconium Ileus Sandeep Hambarde*, Pradnya Bendre* Abstract Isolated meconium ileus as such is relatively rare. Two neonates presented with features of intestinal obstruction. On exploration, features of meconium were present. Temporary ileostomy with postoperative distal washes and medical management was done, followed by ileostomy closure at 6 months of life. Workup for cystic fibrosis and associated anomalies was negative. Both are thriving well at one year followup. Introduction econium ileus is the intestinal Mobstructive variant of cystic fibrosis 1 (CF) or mucoviscidosis. Approximately 15% to 20% of infants with cystic fibrosis also present with intestinal obstruction related to meconium ileus. incidence of cystic fibrosis is 1 in 15,000 in African- 1,2 Americans, and much less in Asians. In the intestine, absence of deficient chloride transport leads to the migration of water out of the intestinal lumen with inspisation of meconium and subsequent 2,3,9 formation of an obstructive state. Case Report Case 1 Day one neonate presented with gross abdominal distension, bilious vomitings and not passed meconium since birth. Child was septic with leucocytosis, positive C reactive protein and was dehydrated. Abdominal skin was tense, shiny and bowel loops were palpable. (figure1) Xray revealed gas filled small bowel loops with distal paucity. (figure2) Ultrasound showed features of small bowel obstruction. After stabilisation, neonate was Fig. 1 : Clinical picture with skin inflammation and palpable bowel loops Fig. 2 : X-ray abdomen with gas filled small bowel loops explored. There was presence of grossly dilated jejunum with collapsed ileum and dilated ileocolic junction. (Fig. 3) Bombay Hospital Journal, Vol. 54, No. 1, 2012 113
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Isolated Meconium Ileus · distension, bilious vomiting, and failure to pass meconium within 48 hours.8 Characteristic radiologic features include varying-sized loops of distended
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*Dept. of Paediatric Surgery, B J Wadia Hospital, Parel, Mumbai-400 012.
Isolated Meconium Ileus
Sandeep Hambarde*, Pradnya Bendre*
Abstract
Isolated meconium ileus as such is relatively rare. Two neonates presented with
features of intestinal obstruction. On exploration, features of meconium were
present. Temporary ileostomy with postoperative distal washes and medical
management was done, followed by ileostomy closure at 6 months of life. Workup for
cystic fibrosis and associated anomalies was negative. Both are thriving well at one
year followup.
Introduction
econium ileus is the intestinal Mobstructive variant of cystic fibrosis 1(CF) or mucoviscidosis. Approximately
15% to 20% of infants with cystic fibrosis
also present with intestinal obstruction
related to meconium ileus. incidence of
cystic fibrosis is 1 in 15,000 in African-1,2Americans, and much less in Asians. In
the intestine, absence of deficient chloride
transport leads to the migration of water
out of the intestinal lumen with
inspisation of meconium and subsequent 2,3,9formation of an obstructive state.
Case Report
Case 1
Day one neonate presented with gross
abdominal distension, bilious vomitings and not
passed meconium since birth. Child was septic with
leucocytosis, positive C reactive protein and was
dehydrated.
Abdominal skin was tense, shiny and bowel
loops were palpable. (figure1)
Xray revealed gas filled small bowel loops with distal
paucity. (figure2)
Ultrasound showed features of small bowel
obstruction. After stabilisation, neonate was
Fig. 1 : Clinical picture with skin inflammation and
palpable bowel loops
Fig. 2 : X-ray abdomen with gas filled
small bowel loops
explored. There was presence of grossly dilated
jejunum with collapsed ileum and dilated ileocolic