Journal of Ultrasound in Medicine, Vol 16, Issue 4 263-266, Copyright © 1997 by American Institute of Ultrasound in Medicine
Neonatal ultrasonography to distinguish between meconium ileus and ileal atresia
M. R. Neal, J. J. Seibert, T. Vanderzalm and C. W. Wagner
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, USA.
Meconium ileus can be difficult to distinguish from ileal atresia on plain
radiographs and on contrast enema. Both show a microcolon in the face of a
small bowel obstruction. The treatment of the two is very different.
Meconium ileus obstruction may be relieved medically by contrast enema;
ileal atresia requires prompt surgical intervention. This study was made to
determine if abdominal ultrasonography might be helpful in distinguishing
between these two entities. Abdominal ultrasonograms from the past 10 years
of all patients with these two diseases who were studied with preoperative
ultrasonography at Arkansas Children's Hospital were reviewed. Six of 16
patients with meconium ileus had preoperative ultrasonograms. All six
patients with meconium ileus had multiple loops of bowel filled with very
echogenic thick meconium. Four of 22 patients with ileal atresia had
preoperative ultrasonograms. These four patients with ileal atresia had
dilated loops of bowel filled with fluid and air. None had a dilated bowel
filled with thick echogenic contents. Preoperative abdominal
ultrasonography is proposed as a simple method for distinguishing between
these two disease entities with very different treatment plans.
