What is meconium ileus?
Cystic fibrosis is an inherited disorder caused by a genetic mutation which causes thickening of the mucus and primarily affects the respiratory tract and pancreatic function. Cystic fibrosis leads to hardening of meconium and prevents its evacuation.
Meconium ileus may be:
- Simple meconium ileus: Simple obstruction in the small intestines resulting in dilatation of the bowel above the obstruction, and bowel wall thickening.
- Complicated meconium ileus: Intestinal obstruction complicated by conditions such as intestinal twisting, perforation and infection.
How is meconium ileus treated?
If the newborn has abdominal distension or other symptoms of meconium ileus, the initial medical treatment involves:
- Initiation of resuscitation of the infant
- Administration of IV fluids
- Gastric decompression by removing the gas in the digestive tract
- Administration of antibiotics
- Imaging test to evaluate the cause for abdominal distension
- Meglumine diatrizoate enema
A diagnosis of a simple meconium ileus is most often treated with an enema, though some infants may require surgery. The administration of enema involves the following steps:
- Prepare the infant with adequate hydration, supplemental electrolytes and antibiotics.
- Administer enema with meglumine diatrizoate (Gastrografin), a water- soluble substance that softens the meconium, and also acts as a contrast medium for continuous X-ray (fluoroscopy) to monitor the process.
- Continue hydration with IV fluids.
- Monitor the baby closely for the next few hours.
- Administer additional enemas if required, until the meconium is completely evacuated.
- Imaging tests to confirm complete evacuation of the meconium.
- Administer supplemental pancreatic enzymes after obstruction is cleared, usually within 48 hours, if the baby is diagnosed with cystic fibrosis.
Potential complications of Gastrografin include:
- Perforation of the bowel
- Hypovolemic shock (shock from loss of fluids, which must be carefully monitored and managed with supplemental IV fluids)
- Ischemia (reduced blood supply to the tissues)
When is surgery indicated for meconium ileus?
Surgical treatment is indicated if the newborn has complicated meconium ileus, with one or more of the following conditions:
- Persistent abdominal distension
- Enlarging abdominal mass
- Volvulus (twisting of a loop of intestine)
- Atresia (malformation of intestine)
- Necrosis (tissue death)
- Meconium peritonitis (inflammation of peritoneum, the abdominal membrane) and pseudocyst formation from the spillage of meconium through the perforation
What are the surgical treatments for meconium ileus?
Surgical treatments for meconium ileus are individualized for each infant. A pediatric surgeon performs the surgery with the baby under general anesthesia.
Prior to a surgical procedure
- The infant undergoes imaging tests
- The neonatal care team
- Administers IV fluids and antibiotics
- Performs gastric decompression
The surgical treatments for meconium ileus may involve one or more of the following procedures:
- Enterostomy: A procedure to make one or more openings (stomas) in the abdomen to insert small tubes into the intestine. The tubes are used to irrigate, decompress the bowel, and also for feeding. The tubes are removed once the obstruction is completely cleared.
- Resection: Removal of the affected portion of the intestine.
- Anastomosis: Anastomosis is a procedure to connect the severed ends of the bowel after a resection.
- Transplantation: Intestinal and/or liver transplantation because of cystic fibrosis associated liver damage.
After surgery, the baby’s hydration and electrolyte requirements are managed carefully. Infants who have surgery for simple meconium ileus with cystic fibrosis may receive breast milk or formula milk, pancreatic enzymes and vitamins.
Babies who have a complex surgical procedure for complicated meconium ileus may receive diluted, pre-digested infant formula through the tube, until they are able to feed orally. Pancreatic enzymes are administered orally after the baby starts oral feeding.
In addition to surgical risks such as wound infection and bleeding, complications from surgical procedures for meconium ileus include the following:
- Excessive fluid and sodium loss in infants who undergo removal of a significant portion of the intestines.
- Adverse effects on the development of the colon and the growth of beneficial bacteria in the colon below the stoma, which is nonfunctional until the enterostomy tubes are removed.
- Excessive gastric acid in the shortened intestines can cause malabsorption of nutrients (short bowel syndrome).
Latest Pregnancy News
Daily Health News
Health Solutions From Our Sponsors
Top How Is Meconium Ileus Treated Related Articles
Can You Get Cystic Fibrosis at Any Age?Cystic fibrosis is classically a disease of childhood that progresses into adulthood. If you have a genetic defect related to cystic fibrosis (CF), you are more likely to be born with cystic fibrosis. The symptoms might appear later, and hence, the age at diagnosis varies widely.
How Is a Person's Life Affected By Cystic Fibrosis?How long can you live with cystic fibrosis? Learn the signs of cystic fibrosis and what to do if someone you know has cystic fibrosis.
Common Infant IllnessesWatch this slideshow to see common symptoms and home treatment for infant and childhood illnesses including fever, nausea, constipation and more.
Cystic FibrosisCystic fibrosis is a disease of the mucus and sweat glands. Cystic fibrosis is an inherited disease. The outcome of the disease leaves the body malnourished, with bulky and fouls smelling stools, vitamin insufficiency, gas, painful or swollen abdomen, infertility, susceptible to heat emergencies, and respiratory failure. There is no cure for cystic fibrosis, treatment of symptoms is used to manage the disease.
Cystic Fibrosis Life SpanCystic fibrosis (CF) is a progressive disease that needs daily care. Though a patient needs to take medications lifelong, most people with cystic fibrosis are usually able to attend school and work. The improvement in screening and treatments mean that people with CF now may live into their mid- to late 30s or 40s, and some are living into their 50s.
diatrizoate meglumine and diatrizoate sodium-solution, Gastrografin, MD-Gastroview
How Do You Do CPR On a Newborn?Neonatal resuscitation (CPR) provides oxygen, stimulates breathing and gets the heart to start pumping normally. Most premature babies and babies with certain congenital conditions require extensive resuscitation.
Why Is Meconium Ileus Diagnostic for Cystic Fibrosis?Meconium ileus is an obstruction in the small intestine caused by thick, congealed meconium, the first stool passed by a newborn baby. Cystic fibrosis, a genetic disorder, is a common cause of this problem.
New Parents MistakesParenting a child isn't easy. Explore the top 10 mistakes that new parents make. Discover newborn parenting tips for breastfeeding, learn to deal with crying babies, child's fevers, and more.
Newborn Infant Hearing ScreeningA newborn infant hearing screening is performed before a child is discharged from the hospital. If an infant doesn't pass the test, a rescreen is performed. Detecting hearing loss at an early age increases a child's chance of having a healthy and more productive life. There are two methods of testing hearing in infants: auditory brainstem response (ABR) and otoacoustic emission (OAE). Both tests are accurate, automated, and don't require a visible response from the infant.
Pregnancy: Multiple Births, Twins, Triplets, and MoreMultiple births occur when a woman bears twins, triplets, or even more babies during pregnancy. More multiples are born today thanks to assisted reproductive technology (ART), including in vitro fertilization using fertility drugs. Women carrying multiples often give birth via C-section.
Sweat Chloride Test (Cystic Fibrosis)The sweat chloride test is a common test used to evaluate a patient suspected of having cystic fibrosis. Cystic fibrosis is a genetic disease common in Caucasians. The sweat chloride test is a fairly simple and painless procedure.
Why Would A Newborn Need A Ventilator?Some babies may have trouble breathing. Respiratory distress or failure may be the result of underdeveloped lungs or a congenital condition. The mechanical ventilator provides oxygen until the baby can breathe unassisted.