What's the most likely diagnosis?
- Newborn with abdominal distension and bilious vomiting
Supine view of the abdomen
- Duodenal atresia
- Esophageal atresia
- Meconium ileus
- Diverticulitis
- Meconium ileus-equivalent syndrome
Additional Image - Contrast enema examination
Additional Image
Single supine image from a contrast enema examination
Answer:
3. Meconium ileus
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Meconium ileus
General Considerations
- Obstruction of the small bowel in the terminal ileus from impacted meconium
- May develop in utero and manifests within 48 hours of birth
- Meconium is normally evacuated within first 6 hours
- Earliest sign of cystic fibrosis
- Autosomal recessive
- Predominantly Caucasians
- Diseased exocrine gland function affecting primarily the lungs and the pancreas
- May also be seen with other pancreatic disease such as stenosis of the pancreatic duct
- In a few cases, the pancreas is normal and there is decreased intestinal motility
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