A 3,809-g newborn male infant had been delivered vaginally after an uneventful prenatal course and full-term gestation. He was transferred to Milwaukee Children's Hospital for evaluation of abdominal distention.
Except for the abdominal distention, physical examination did not show any abnormalities. Progressive distention and the onset of bilious vomiting prompted additional examinations. A roentgenogram of the abdomen was obtained (Figure). Laboratory values were normal. Operative exploration was then performed.
Denouement and Discussion
Ileal Atresia With Meconium Peritonitis: Meconium Pseudocyst
Anteroposterior view of supine abdomen. Note dilated loops of small bowel. Arrows indicate right midabdominal mass with thin curvilinear rim of calcification.A plain roentgenogram of the abdomen (Figure) showed a calcified right midabdominal mass and multiple, dilated loops of small bowel consistent with a distal small-bowel obstruction. Initial roentgenographic examination of a neonate with abdominal distention usually includes supine and upright abdominal films. Within three hours of birth, air
Boedecker RA, Babbitt DP, Sty JR, Young LW. Radiological Case of the Month. Am J Dis Child. 1982;136(8):741–742. doi:10.1001/archpedi.1982.03970440085026