| ID | 407 |
|---|---|
| Name | MECONIUM ILEUS |
| Cause | |
| Signs Symptoms | |
| Diagnosis | Diagnosis: 1. Plain x-ray of the abdomen show a typical hazy or ‘ground glass’ appearance in the right lower quadrant. Moderately dilated loops of bowel with-out fluid level may present. Patchy calcification may be noted usually in the flanks may present in meconium peritonitis. 2. Gastrografin enemas should be used with caution in the diagnosis and treatment of meconium ileus. |
| Investigations | |
| Management | |
| Introduction | It is the neonatal manifestation of fibrocystic diseases of the pancreas. The terminal ileum become filled with meconium mixed with viscid mucus and during the later months of foetal life this mixture becomes progressively inspissated. At times the coil filled with inspissated meconium, which can be felt as a rubbery mass and obstruct the intestine. |
| History | |
| Etiology | |
| Clinical Features | Clinical manifestations: 1. The patient may be born with abdominal distension. Obstruction may develop shortly after birth and progress as a result of swallowed air. 2. Distension often results from meconium peritonitis. 3. Vomiting may occur early with bilirubin stained vomitus 4. There is usually no stool. 5. Pneumo-peritonium should be suspected if abdominal distension increases rapidly within the first 24 hours of life, if the liver is less dull on percussion, or if free fluid is evident within the abdomen. 6. No meconium will pass through rectum even after digital examination. |
| Preventions | |
| Treatment | Treatment: A. General measures - 1 . Fluid and electrolyte imbalance should be corrected. 2. Prophylactic antibiotics. B. Specific measures - 1. Gastrografin enema- to reduce the obstruction. The material should be allowed to flow around the pellets of stool in the terminal ileum & proximal small bowel. The enema may have to be repeated after 8-12 hours. 2. A simple small ileotomy is done within a purse string suture, if gastrografin enema failed. C. Treatment of complications- Such as- 1 . Meconeum aspiration syndrone 2. Meconium peritonitis. 3. Volvulus neonatorum. 4. Atresia. |
| Complications | |
| Prognosis | |
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