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Contrast enema depiction of small-bowel volvulus in complicated neonatal bowel obstruction

Oscar M Navarro1, Alan Daneman, Stephen F Miller

  • 1Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. oscar.navarro@sickkids.ca

Pediatric Radiology
|September 18, 2004
PubMed

Insights

Diagnosing complicated meconium ileus (MI) is challenging. A unique spiral small bowel appearance on contrast enema can indicate volvulus and the need for surgery in neonates with MI.

Area of Science:

  • Neonatal surgery
  • Pediatric radiology
  • Gastroenterology

Background:

  • Meconium ileus (MI) often presents with surgical complications like volvulus or atresia.
  • Preoperative diagnosis of complicated MI remains difficult, impacting timely surgical intervention.

Observation:

  • Two neonates with complicated small-bowel obstruction were studied.
  • One neonate had MI related to cystic fibrosis; the other did not.
  • Both presented with a distinct spiral appearance of the distal small bowel on contrast enema.

Findings:

  • The spiral appearance on contrast enema correlated with antenatal bowel perforation and volvulus in both cases.
  • This specific radiological finding in complicated MI has not been previously documented.
  • Surgical intervention was required for both neonates.

Implications:

  • Recognizing the spiral small bowel sign on contrast enema can aid in diagnosing complicated MI.
  • This finding suggests the urgent need for surgical management in affected neonates.
  • Improved preoperative diagnosis can lead to better outcomes for neonates with complicated meconium ileus.

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