ABSTRACT
Cystic fibrosis (CF) is the most common serious inherited defect affecting the Caucasian population. Neonatal intestinal obstruction due to inspissated meconium has been identified since the early reports concerning CF and is referred to as meconium ileus. The typical neonate with meconium ileus may appear relatively normal for the first 12–18 hours of life and some tolerate several feeds. Plain abdominal X-rays and decubitus views usually demonstrate similar-sized dilated loops of intestine without air–fluid levels. A “soap bubble” appearance is often noted in the right lower quadrant, a result of air mixing with the thick meconium. The initial diagnostic test is a contrast enema. If the diagnosis of meconium ileus is not apparent from the plain X-rays, a barium enema is the diagnostic procedure of choice. The clinical presentation of distal intestinal obstruction syndrome, formerly referred to as meconium ileus equivalent, includes abdominal pain and decreased stool frequency.
