Meconium ileus is a neonatal intestinal obstruction caused by thickened meconium within the bowel lumen. It occurs in approximately 20% of cystic fibrosis patients and risk factors include a family history of cystic fibrosis or meconium ileus, as well as low birth weight. Thickened meconium leads to obstruction in the bowel, dilation of the proximal ileum, and narrowing of the distal intestine. Symptoms include failure to pass meconium and abdominal distension. Treatment options include non-operative hyperosmolar enemas to break down the thickened meconium or operative resection with enterostomy or primary anastomosis for complicated cases.

1. MECONIUM ILEUS
Mohd Fazrul. 122854

2. • Neonatal intestinal obstruction secondary to
• Meconium within the lumen of the bowel
that has become thickened
INCIDENCE
can occur in approximately 20% of patients with
cystic fibrosis
RISK FACTORS
1. Family history of
• cystic fibrosis
• meconium ileus
2. low birth weight
PATHOGENESIS
1. Accumulated thickened meconium leads to
obstruction in the bowel lumen resulting in
• dilation of the proximal ileum wall and
• narrowing of the distal intestine

3. PRESENTATION
• Symptoms
• failure to rectally pass meconium
• Physical exam
• abdominal distension
• palpable bowel loops
• may have visible peristaltic waves
DIFFERENTIAL DIAGNOSIS
1. Intestinal atresia
2. Hirschsprung disease
3. Volvulu

5. TREATMENT
1. Non-operative
Hyperosmolar enema (e.g., Gastrografin)
 indication
• this is a non-operative approach to treat meconium ileus as this leads to
 breakdown of the thickened meconium which clears the obstruction
• this is typically performed in simple meconium ileus but
 can be used in complicated meconium ileus
2. Operative
Resection with enterostomy or primary anastomosis
 indication
• can be used in cases of simple meconium ileus that does not clear with
hyperosmolar enema
• this is typically performed in complicated meconium ileus

6. REFERENCE