Meconium ileus

Meconium ileus

Inspissated meconium may cause a distal ileal obstruction. A segmental ileal volvulus can follow and create an atresia. If the ileum perforates, it may seal or persist and cause a large meconium pseudocyst. An abdominal radiograph shows obstruction with a ground-glass appearance. Peritoneal calci - fication indicates an antenatal perforation. Simple cases are managed with a water-soluble hyperosmolar contrast enema (diatrizoate) using fluoroscopy in a well-hydrated neonate ( Figure 18.9 ). Complicated cases require a laparotomy and enterotomy for a luminal washout; a temporary stoma may be required. Postoperatively , N-acetylcysteine can be given by nasogastric tube and as enemas to loosen residual meconium. Genetic investigations look for defects in the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Meconium ileus

Inspissated meconium may cause a distal ileal obstruction. A segmental ileal volvulus can follow and create an atresia. If the ileum perforates, it may seal or persist and cause a large meconium pseudocyst. An abdominal radiograph shows obstruction with a ground-glass appearance. Peritoneal calci - fication indicates an antenatal perforation. Simple cases are managed with a water-soluble hyperosmolar contrast enema (diatrizoate) using fluoroscopy in a well-hydrated neonate ( Figure 18.9 ). Complicated cases require a laparotomy and enterotomy for a luminal washout; a temporary stoma may be required. Postoperatively , N-acetylcysteine can be given by nasogastric tube and as enemas to loosen residual meconium. Genetic investigations look for defects in the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Meconium ileus

Inspissated meconium may cause a distal ileal obstruction. A segmental ileal volvulus can follow and create an atresia. If the ileum perforates, it may seal or persist and cause a large meconium pseudocyst. An abdominal radiograph shows obstruction with a ground-glass appearance. Peritoneal calci - fication indicates an antenatal perforation. Simple cases are managed with a water-soluble hyperosmolar contrast enema (diatrizoate) using fluoroscopy in a well-hydrated neonate ( Figure 18.9 ). Complicated cases require a laparotomy and enterotomy for a luminal washout; a temporary stoma may be required. Postoperatively , N-acetylcysteine can be given by nasogastric tube and as enemas to loosen residual meconium. Genetic investigations look for defects in the cystic fibrosis transmembrane conductance regulator (CFTR) protein.