title: Contrast enema depiction of small-bowel volvulus in complicated neonatal bowel obstruction.
abstract: About one-half of patients with meconium ileus (MI) present with a complication such as volvulus, atresia, meconium peritonitis or giant cystic meconium peritonitis. The treatment of these complications requires surgery. However, the preoperative diagnosis of complicated MI is difficult. We describe two neonates with complicated small-bowel obstruction, one with MI related to cystic fibrosis and the other not related to cystic fibrosis. In both, contrast enema depicted a spiral appearance of the distal small bowel, which at surgery proved to be the result of volvulus associated with antenatal bowel perforation. This appearance of the small bowel on contrast enema in this clinical setting has not been previously described. The recognition of this spiral appearance of the distal small bowel suggests the need for surgery.
authors.affiliation: Department of Diagnostic Imaging, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. oscar.navarro@sickkids.ca
authors.forename: Oscar M
authors.initials: OM
authors.lastname: Navarro
authors.forename: Alan
authors.initials: A
authors.lastname: Daneman
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Miller
mesh_terms: D003287:Contrast Media; D003550:Cystic Fibrosis / Q000150:complications / Q000175:diagnosis; D004733:Enema; D005260:Female; D006801:Humans; D045823:Ileus / Q000150:complications / Q000175:diagnosis; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis*; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000209:etiology*; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology; D045822:Intestinal Volvulus / Q000150:complications / Q000175:diagnosis*; D007421:Intestine, Small / Q000002:abnormalities*; D008470:Meconium / Q000000981:diagnostic imaging; D011860:Radiography, Abdominal; D018084:Ultrasonography, Interventional
chemical_list: D003287:Contrast Media