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A neonate develops bile-stained vomiting and progressive abdominal distention, and does not pass meconium
over the first two days of life. The anus is patent, and the bowel loops are palpable. Plain radiograph shows
bubbly meconium in the right lower quadrant. No localized areas of constriction or other abnormalities are
noted.
Which of the following is most likely etiologically related to this infant's condition?
A. Cystic fibrosis
B. Hirschsprung's disease
C. Meckel's diverticulum
D. Omphalocele
E. Polycystic kidney disease

b........

A?

b?

The correct answer is A. The baby has meconium ileus, which is a manifestation of cystic fibrosis due to the
abnormally viscid pancreatic secretions which "get stuck" in the small bowel. Meconium ileus can cause gut
perforation with peritonitis and intraperitoneal calcifications (that may be visible on plain film). Meconium
ileus