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February 1977

Radiological Case of the Month

Author Affiliations

From the Department of Pediatrics and Surgery, Worcester (Mass) City Hospital.

Am J Dis Child. 1977;131(2):229-230. doi:10.1001/archpedi.1977.02120150111022

Clinical History.—A 2,568 gm girl was born following an uneventful 38-week gestation. The initial physical examination did not reveal any abnormalities. Abdominal distention and a doughy right-sided mass were noted at 36 hours of age. A plain roentgenogram of the abdomen showed a mass appearing to be meconium (Fig 1). Following a barium enema, the meconium was spontaneously passed and the patient was discharged from the hospital. Sweat iontophoresis was unsuccessful at this time.

After discharge, the infant was lost to follow-up until 4% months of age, when she was seen at the emergency room with a normal history until that day, when she seemed irritable, refused solid feedings, and appeared less interested in her formula. One-half hour prior to arrival in the emergency room, she became dusky and had difficulty in breathing. On examination she appeared to be in shock, intensely cyanotic, and in severe respiratory distress. The left side of the chest was tympanic and the breath sounds were diminished. The heart sounds were best heard over the right anterior part of the chest. Arterial

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