Sweating It Out: When Meconium Ileus Is Not Cystic Fibrosis-A Case Report

Area of Science:

• Neonatal Medicine
• Gastroenterology
• Genetics

Background:

• Meconium ileus (MI) is a bowel obstruction caused by inspissated meconium, primarily in the terminal ileum.
• MI is strongly associated with cystic fibrosis (CF), occurring in up to 24.9% of individuals with the Delta F508 mutation.
• Non-CF associated MI is rare, while MI presentation varies from simple to complex, impacting management and outcomes.

Purpose of the Study:

• To present a case report of a neonate diagnosed with meconium ileus.
• To discuss the differential diagnosis, diagnostic testing, and treatment of meconium ileus.
• To review radiographic modalities and nursing management for simple and complex MI.

Main Methods:

• Case report of a 32-week-gestation female infant with abdominal distention.
• Review of diagnostic workup including differential diagnosis and radiographic confirmation.
• Discussion of treatment strategies, including contrast enemas and surgical intervention.

Main Results:

• The infant presented with gross abdominal distention, leading to the diagnosis of meconium ileus.
• Radiographic modalities were crucial in confirming the diagnosis and assessing the obstruction.
• Management strategies were tailored based on whether the MI was simple or complex.

Conclusions:

• Meconium ileus diagnosis and management require a comprehensive approach, considering its association with cystic fibrosis.
• Prompt identification and appropriate treatment, whether clinical or surgical, are vital for improving outcomes.
• Understanding the challenges for infants and families is essential for holistic care.