Complicated Meconium Ileus: Case Report with Review of Literature

Meconium ileus (MI) is a unique form of neonatal obstruction almost always associated with Cystic Fibrosis. Uncomplicated cases respond well to nonsurgical management. However, few patients develop complications in the postnatal period, requiring emergency operation. A two day old newborn presented with clinical features of low intestinal obstruction suspected to be due to meconium ileus. After resuscitation, a trial of conservative treatment, with Mucomist enemas, was attempted without success. Exploratory laparotomy revealed typical MI with midileal volvulus. Resection of the gangrenous, volvulated ileum with manual evacuation of meconium, both proximally and distally, followed by end to end anastomosis was done. Patient made uneventful recovery. Follow up tests did not reveal cystic fibrosis, the growth and development of the baby has been uneventful.