Ultrasound- guided Hydrostatic (Hydrocolonic) Treatment of Meconium Ileus: A Preliminary Report

Background Meconium ileus (MI) is one type intestinal obstruction due to inspissated meconium at the level of the terminal ileum. The purpose of this study is to present the non-ionizing ultrasound-guided approach for the treatment of meconium ileus.
Materials and Methods This study was performed, prospectively, at Dr. Sheikh and Akbar children's Hospitals, Mashhad University of Medical Science (Mashhad city, Iran) from March 2017 to March 2018. The 21 newborn patients with suspicious meconium ileus were referred to Radiology department for contrast enema and ultrasound examination. The hydro colonic ultrasound-guided treatment was considered for four cases with simple form of meconium ileus. Ultimately, plain abdominal radiography was taken to documentation of entrance of solution to dilated proximal loop and evaluation of probable complications.
In ultrasound exam, air bubbles are floating in fluids on proximal dilated loops, and no air is seen in bowel loops contain inspissated meconium. Ultrasound showed a collapsed microcolon in addition to inspissated meconium as a hypoechoic beaded intraluminal material in comparison to adjacent bowel mucosa. During ultrasound-guided enema, overt distention of unused colon and ileum was seen with coating and detachment of meconium plaques from bowel wall and floating and movement of the plaques toward the dilated proximal loops. The successful treatment in our study was occurred in two-third of cases.
Conclusion Ultrasound-guided hydrostatic (hydro colonic) treatment can be a non-ionizing nonsurgical procedure for successful treatment of newborns with uncomplicated meconium ileus.