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Meconium ileus equivalent: treatment with Hypaque enema
Abstract:
Meconium ileus equivalent is an unusual cause of intestinal obstruction in adults. In this paper we report of our experience with a 29-year-old male with a long-standing history of cystic fibrosis and recurrent abdominal pain. Following barium examination of the stomach and small bowel, the patient developed increasing abdominal pain and evidence of meconium ileus equivalent as the etiology of his small bowel obstruction. The obstruction was relieved by administration of a 20% sodium diatrizoate enema and oral saline cathartics. The clinical and radiographic findings of meconium ileus equivalent are reviewed, as is the use of water-soluble contrast agents in the management of this condition. The role of prior barium study in precipitating this condition is discussed.
Insights
Meconium ileus equivalent, a rare adult intestinal obstruction, can be precipitated by barium studies in cystic fibrosis patients. Prompt treatment with contrast enemas and saline effectively relieved the obstruction.
Area of Science:
- Gastroenterology
- Pediatric Surgery
- Radiology
Background:
- Meconium ileus equivalent (MIE) is an uncommon cause of intestinal obstruction in adults.
- Cystic fibrosis (CF) patients are at higher risk for developing MIE.
- Recurrent abdominal pain is a common symptom in adult CF patients.
Observation:
- A 29-year-old male with a history of CF and chronic abdominal pain presented with acute small bowel obstruction.
- The obstruction developed after a barium examination of the stomach and small bowel.
- Clinical and radiographic findings suggested MIE as the cause of obstruction.
Findings:
- The patient's obstruction was successfully relieved using a 20% sodium diatrizoate enema and oral saline cathartics.
- Water-soluble contrast agents are effective in managing MIE.
- Barium studies may precipitate MIE in susceptible individuals.
Implications:
- This case highlights the importance of considering MIE in adult CF patients with small bowel obstruction, especially after barium studies.
- Water-soluble contrast enemas are a valuable therapeutic tool for MIE.
- Further investigation into the role of barium contrast in precipitating MIE is warranted.