DR.MOHAMMED IRFAN SHEIKH8 months ago

Visible Intestinal Peristalsis in a Neonate

A male infant was delivered as the third trichorionic triamniotic triplet at 28 weeks of gestation by emergency cesarean section owing to growth arrest. His birth weight was 1124 g, and the Apgar scores were 5 at 1 minute and 6 at 5 minutes. On the first day of life, he had bilious vomiting and abdominal distention with visible intestinal peristalsis (see video), and he was unable to pass meconium. An abdominal radiograph showed distended bowel loops. In such infants, this finding may be the result of any form of distal bowel obstruction, including meconium-related ileus, intestinal atresia, malrotation, and Hirschsprung’s disease. The administration of water-soluble contrast enemas can be not only diagnostic but also therapeutic. However, surgical decompression is occasionally required. In this case, a diagnosis of meconium-related ileus was made. Repeated water-soluble contrast enemas were administered to clear the intestines of all plugs, and the vomiting and abdominal distention resolved. The patient was discharged on day 93 with full oral feeding.