meconium ileus


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ileus

 [il´e-us]
failure of appropriate forward movement of bowel contents. It may be secondary to either mechanical obstruction of the bowel (mechanical ileus) or a disturbance in neural stimulation (adynamic ileus). Ileus is a surgical emergency that may or may not require surgical intervention; the cause needs to be established promptly.

Adynamic (or paralytic) ileus often accompanies peritonitis and is also found accompanying the colicky pains of gallstones or kidney stones; following spinal cord injury, pneumonia, or other generalized conditions; or being caused by peritoneal contamination by pus (from a perforated appendix) or acid (from a perforated ulcer). Mechanical ileus is that due to adhesions, ischemia, tumor, or stone and requires prompt decompression of the bowel to prevent perforation.
Symptoms. The principal symptoms of ileus are abdominal pain and distention, constipation, and vomiting in which the vomitus may contain fecal material. If the intestinal obstruction is not relieved, the circulation in the wall of the intestine is impaired and the patient appears extremely ill with symptoms of shock and dehydration.
Treatment. Distention of the abdomen is relieved by decompression, which involves intubation with a long, balloon-tipped tube (e.g., miller-abbott tube) that extends to the site of the obstruction, and use of constant suction. Because of the disruption in absorption of fluids and nutrients from the intestinal tract, fluids, electrolytes, and glucose are given intravenously. Surgical intervention to remove the cause of ileus is usually necessary when the obstruction is complete or the bowel is likely to become gangrenous. The type of surgical procedure will depend on the condition of the bowel and the cause of the obstruction. In some cases ileostomy or colostomy, either temporary or permanent, may be necessary. In cases of paralytic ileus due to causes other than contamination by pus or acid, tube decompression may be sufficient, but even in these patients, surgery may be needed to protect the bowel from overdistention and perforation. See also intestinal obstruction for patient care.
adynamic ileus that caused by inhibition of bowel motility; see ileus.
dynamic ileus (hyperdynamic ileus) spastic ileus.
mechanical ileus that caused by a mechanical cause, such as hernia, adhesions, or volvulus; see ileus.
meconium ileus ileus in the newborn due to intestinal obstruction by thick meconium.
paralytic ileus adynamic ileus.
spastic ileus that due to persistent contracture of a bowel segment.
ileus subpar´ta ileus due to pressure of the gravid uterus on the pelvic colon.

me·co·ni·um il·e·us

intestinal obstruction in the fetus and newborn following inspissation of meconium and caused by lack of trypsin; associated with cystic fibrosis.

meconium ileus

A condition characterised by obstruction of the neonatal intestine by meconium that may be confined to the ileus, a finding characteristic of cystic fibrosis.
 
Clinical findings
Non-passage of stool in the first two days of life, vomiting, abdominal distension.

Complications
Volvulus, intestinal infarction.
 
DiffDx
Meconium “plugging” of the rectum may also signal the presence of Hirschsprung’s disease, which is histologically characterised by segmental aganglionosis.

meconium ileus

Meconium plug syndrome Obstetrics A condition characterized by obstruction of the neonatal intestine by meconium that may be confined to the ileus, a finding characteristic of cystic fibrosis Clinical Non-passage of stool in the first 2 days of life, vomiting, abdominal distension Complications Volvulus, intestinal infarction

me·co·ni·um il·e·us

(mě-kō'nē-ŭm il'ē-ŭs)
Intestinal obstruction in the fetus and newborn following inspissation of meconium; caused by lack of trypsin; associated with cystic fibrosis.

meconium ileus

Obstruction of the intestine in a new-born baby with CYSTIC FIBROSIS due to failure of digestion of the MECONIUM which becomes very firm and packs the lower ILEUM with a putty-like material. There is vomiting and distention. Surgery may be needed to remove the obstructed section of the bowel.
References in periodicals archive ?
Effect of meconium ileus on the clinical prognosis of patients with cystic fibrosis.
Detection of a cystic fibrosis modifier locus for meconium ileus on human chromosome 19q13.
Nutritional status of patients with cystic fibrosis with meconium ileus: a comparison with patients without meconium ileus and diagnosed early through neonatal screening.
This patient was not born out of consanguinity marriage and this patient showed the symbols of malnutrition, respiratory problems and meconium ileus. In previous studies, in the common wealth of independent states (CIS), the mutation of S466X with [DELTA]F508 in the form of compound heterozygous was determined.
The patients had the disorders of respiratory-digestive and meconium ileus and the parents of the patient had no genetic relationship (1).
The abnormal patterns observed in CF reflect meconium ileus and are not observed in CF carriers; however, these patterns are not specific to CF and can be observed in fetal digestive tract malformations, cytomegalovirus infection, or fetal distress (14).
The latter, born without meconium ileus, was diagnosed at the age of 2 years; the sweat chloride result was 70 mEq/L.
The patient, born without meconium ileus, was diagnosed at the age of 3 months on the basis of pulmonary distress and failure to thrive.
Genotype 4016insT/4016insT R1158X/R1158X Ethnic origin Southern Italy Southern Italy Present age 23 years Death at 20 years Age at diagnosis 2 years 3 months Meconium ileus No No Nasal polyposis No No Lung involvement Severe Very severe FEV 1, % of predicted 38 18 Liver involvement Cholestasis Moderate Pancreatic insufficiency Moderate Moderate Sweat chloride 70 mEq/L 98 mEq/L Genotype L1065P/L1065P Ethnic origin Southern Italy Present age 18 years Age at diagnosis 1 year Meconium ileus No Nasal polyposis No Lung involvement Mild FEV 1, % of predicted 62 Liver involvement Mild Pancreatic insufficiency Moderate Sweat chloride 93 mEq/L Table 3.
Meconium Ileus (19/286, 6.64%) (Picture 6) terminal ileum relatively small and contained concretions of grey, inspissated meconium (9).
Meconium Ileus: demonstration of the meconium as on barium enema study--American Journal of Roentgenology; September 1965,9(1).
No Congenital Anomaly Age Range Male 1 Hirschsprung's Disease 0-12 yrs 114 2 Omphalomesenteric duct 0-15 yrs 37 remnants 3 Intestinal Atresia 0-1 month 17 4 Meconium Ileus 0-1 month 10 5 Duplication Cysts 0-10 yrs 8 6 Mesenteric Cysts 0-5 yrs 5 7 Chylolymphatic Cysts 1-10 yrs 5 8 Web/Stenosis 0-8 yrs 3 9 Meconium Cyst 0-7 days 2 10 Malrotation 0-10 month 1 11 Heterotopic Pancreas 0-5 yrs 1 12 Inspissated Bile Syndrome 1-6 month 2 13 Recto-vaginal Fistula 1-5 yrs 0 14 Tracheo-esophageal fistula 1yr 0 (TOF) 15 TOF + Esophageal Atresia 5 days 0 16 Anal Fistula 12 days 1 17 Ectopia vesicae with 7 Months 1 Duplication Cysts 18 Imperforate Anus 1 day 1 Total 208 78 286 S.