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Case of the Week 320

What's the most likely diagnosis?

  • Newborn with abdominal distension and bilious vomiting

Supine view of the abdomen

  1. Duodenal atresia
  2. Esophageal atresia
  3. Meconium ileus
  4. Diverticulitis
  5. Meconium ileus-equivalent syndrome

Additional Image - Contrast enema examination


Additional Image

Single supine image from a contrast enema examination


3. Meconium ileus

More (Click Discussion Tab)

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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