Archives of the AFIP -- RadioGraphics

Figure 5: Meconium ileus in a neonate in whom enema therapy was performed. Panel A Supine, frontal, abdominal radiograph shows intestinal dilatation, which is especially severe in the right lower quadrant where a soap bubble pattern is evident. A minimal amount of residual contrast material from a prior incomplete enema examination is present in the rectum. Findings suggest distal intestinal obstruction. Panel B Supine, cross-table lateral projection reveals the lack of sharp air-fluid interfaces within the dilated bowel loops. The partially opacified rectum is diminished in caliber. Panel C Image from a water-soluble contrast material enema examination demonstrates an unused microcolon and impacted distal small bowel filled with inspissated meconium-the origin of the soap bubble pattern seen in a. The cecum (arrow) is in a subhepatic position, having failed to descend into the right flank because of the abnormally dilated bowel. The more dilated, air-filled, proximal intestinal loops have not been opacified by the retrograde flow of contrast material. Panel D Image obtained 28 hours later shows complete opacification of the small bowel has been achieved following multiple, repeat water-soluble contrast material enema procedures. Panel E Abdominal radiograph obtained 1 day later shows complete resolution of intestinal obstruction and a very small amount of residual contrast material in the nondistended colon.

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