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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


Answer:


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

 

More ...


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LearningRadiology.com is an award-winning educational site aimed primarily at medical students and radiology residents-in-training, containing  lectures, handouts, images, Cases of the Week, archives of case quizzes, flashcards of differential diagnoses and “most commons” lists, primarily in the areas of chest, GI, cardiac, and bone radiology.