Meconium ileus is a condition caused by the obstruction of meconium, which is the newborn's first stool, from passing through the anus after birth.

In this condition, intestinal contents become trapped and fail to move into the colon or large intestine, making it difficult to expel meconium as the first stool post-birth.

Approximately 5% of infants diagnosed with meconium ileus do not have any associated underlying condition.

Symptoms of Meconium Ileus

Meconium ileus in newborns manifests with the following symptoms:

Abdominal distension.

Greenish vomiting.

Absence of meconium passage.

Causes and Risk Factors of Meconium Ileus

This congenital abnormality occurs in approximately 20% of infants born with cystic fibrosis.

Meconium ileus is characterized by a congenital defect that disrupts pancreatic fluid secretion and the concentration of pancreatic proteolytic enzymes. As a result, meconium, which consists of sloughed-off intestinal cells, lanugo hair, amniotic fluid cells, fetal gut secretions, and swallowed amniotic fluid, becomes abnormally thick and adheres to the wall of the ileum. This leads to accumulation and obstruction near the ileocecal valve and cecum.

Complications of Meconium Ileus

This congenital anomaly may result in more complex conditions due to intrauterine intestinal pressure, including:

Intestinal perforation: A weak spot in the intestinal wall ruptures, allowing intestinal contents to leak into the abdominal cavity, causing peritonitis.

Isolated fluid accumulation: This leads to the formation of a pseudocyst.

Atresia of the small intestine: Caused by partial volvulus of the small intestine.

Diagnosis of Meconium Ileus

Diagnosis is performed using abdominal X-rays, which reveal the absence of air passage into the colon.

Confirmation of cystic fibrosis diagnosis is achieved through:

Sweat chloride test.

Detection of the characteristic genetic mutation.

Treatment of Meconium Ileus

Treatment options include:

1. Non-Surgical Treatment

Meconium can be softened and moved by administering an enema containing dissolving agents, facilitating its passage through the connected intestine to the anus.

2. Surgical Treatment

If the first-line treatment fails, surgery involves injecting acetylcysteine, which dissolves meconium through the intestinal wall. The softened meconium is then extracted using manual compression of the large intestine.

If unsuccessful, the obstructed intestine may need to be resected, and an ostomy is created to divert the intestinal ends to the abdominal wall.

Once normal intestinal function resumes, the intestinal ends are reconnected.

Prevention of Meconium Ileus

There are no established methods to prevent meconium ileus.