Clinical Presentation of Meconium Ileus (MCQ)
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A: Meconium ileus.
Clinical presentation of meconium ileus is with abdominal distension and bilious vomiting.
Viscous meconium in the terminal ileum may cause intestinal obstruction. It may be a manifestation of cystic fibrosis in approximately 10% of the CF population. Therefore, any baby with meconium ileus requires further investigation for CF.
There are often many gas-filled bowel loops, but without air-fluid levels. Air-fluid levels are thought not to occur because the meconium does not provide a good air-fluid interface. There may be a "soapy" mass in the right lower quadrant. A contrast enema will show a microcolon secondary to distal ileal obstruction. Calcification may be seen on a plain radiograph if there has been meconium peritonitis.
Gastrografin enemas may relieve the obstruction, but surgery may also be required.
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