pediatrics
Meconium Ileus
Diagnosis of Meconium Ileus
Plain x-rays If positive, tests for cystic fibrosis Prenatal ultrasonography can detect changes in utero suggestive of cystic fibrosis and meconium ileus (eg, dilated bowel, polyhydramnios), but these changes are not specific. Diagnosis of meconium ileus is suspected in a neonate with signs of intestinal obstruction, particularly if a family history of cystic fibrosis exists. Patients should undergo abdominal x-rays, which show dilated intestinal loops; however, fluid levels may be absent. A “soap bubble” or “ground glass” appearance due to small air bubbles mixed with the meconium is diagnostic of meconium ileus. If meconium peritonitis is present, calcified meconium flecks may line the peritoneal surfaces and even the scrotum. A water-soluble contrast enema reveals a microcolon with an obstruction in the terminal ileum. Patients diagnosed with meconium ileus should be Diagnosis . 