Meconium Ileus

Question 1

Clinical signs

Answer 1

Simple MI - 
Abdominal distension at birth, 
failure to pass meconium, 
bilious vomiting, 
and progressive abdominal distension
dilated loops of bowel with a doughy character that indent on palpation.

Complicated MI - severe abdominal distension , signs of peritonitis

Question 2

Diagnosis is made by

Answer 2

. Prenatal sonographic are hyperechoic masses (ie, inspissated meconium in the terminal ileum), dilated bowel, and inability to visualize the gallbladder.

Abdominal X-ray - unevenly dilated loops of bowel with variable air-fluid levels.
Bubbles of gas
(Soap- bubble appearance )

Contrast barium enema which can be followed by a therapeutic gastrografin enema

diagnosis of CF should be confirmed or refuted by a sweat test.

Question 3

Treatment

Answer 3

Mechanical respiratory support if needed
Gastric decompression
IV Hydration
Gastrografin enema
A limited enterotomy (double-barrelled ileostomy according to Mikulicz, )