MECONIUM ILEUS AND ITS COMPLICATIONS

A REAPPRAISAL OF PLAIN FILM ROENTGEN DIAGNOSTIC CRITERIA

¹ Fellow in Pediatric Radiology from the Children's Bureau Grant No. 153, Department of Health, Education and Welfare, U.S.A. and now Pediatric Radiologist, Mount Sinai School of Medicine, New York, New York.

1. Of 60 patients with cystic fibrosis and intestinal obstruction at birth (meconium ileus) more that half had "complications" of volvulus, atresia and intestinal perforation with meconium peritonitis.

2. The traditional plain film roentgen criteria for meconium ileus (bubblygranular pattern, absence of air-fluid levels) were found to be absent in many "uncomplicated" cases, while confusingly present in some "complicated" cases.

3. In "uncomplicated" meconium ileus, the greatest plain film roentgen problem was the inability to accurately distinguish small bowel from colon obstruction unless a barium enema examination was performed.

4. In "complicated" meconium ileus, the greatest plain film roentgen problem was the inability to suspect complications (such as volvulus) unless calcifications or a mass effect of the volvulus could be seen.

5. The wide, often bizarre spectrum of roentgen findings in "meconium ileus" reflects the varying prenatal intestinal catastrophes secondary to the distal ileal meconium obstruction.^*

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