EXAM: Fluoroscopic enema (water-soluble contrast enema)
INDICATION: 3-day-old male with abdominal distention, and multiple loops of abnormally dilated small bowel on recent abdominal radiographs.
TECHNIQUE: Multiple fluoroscopic images were obtained during the retrograde infusion of water-soluble contrast per rectum and into the colon.
FINDINGS:
Fluoroscopic images show contrast filling a small caliber colon at the region of the sigmoid, descending, and transverse levels. Contrast extends to the right upper quadrant, where multiple filling defects are visualized within the proximal colon. Only a trace amount of contrast is able to reflux into the terminal ileum. Background gas-filled and abnormally dilated small bowel loops are seen throughout the abdomen.
IMPRESSIONS:
Microcolon, with multiple filling defects and an inability to reflux significant contrast into the terminal ileum. These findings are compatible with meconium ileus. Short-interval repeat enema should be considered, although an associated ileal atresia or volvulus are also in the differential diagnosis.
