19. Iontoforesis de pilocarpina
Cloro de 60 mEq/l
100 mg de sudor
Mala respuesta de RN
a pilocarpina
Otros indicadores
Tripsina/quimotripsina
menor 80mg
1905 descripción a partir de obstrucción por pancreas anular1948: irrigacion salina por iliostomia 5 de 8 sobrevivieron
FQ: autosomica recesiva, se acumula meconio por obstruccion y disecamiento del mismo
FQ: autosomica recesiva, se acumula meconio por obstruccion y disecamiento del mismo
Figure 1 :Uncomplicated meconiumileus. Pellets of inspissatedmeconium fill the terminal ileum proximal to a microcolon. Several loops of more proximal ileum contain thick tenacious meconium. (From Leonidas SC, Berdon WE, Baker DH, Santulli TV: Meconiumileus and its complications: a reappraisal of plain film roentgen diagnostic criteria. Am J Roentgenol 1970;108:598.)
Historia familiar FQ 10-33%
Figure 3 :Ultrasound appearance of meconiumileus. Rounded loops of bowel (arrows) full of echogenicmeconium are visualized on this transverse scan.
Uncomplicated meconiumileus. Erect radiograph shows a bubbly pattern reflecting admixture of gas and meconium (not specific for meconiumileus). Note lack of gas-fluid levels, a helpful sign of meconiumileus.
Meconiumileus. At left, a conventional radiograph of a newborn abdomen shows a "mass" in the right lower quadrant (white arrow) made up of loops of ileum with inspissatedmeconium, markedly dilated loops of bowel (black arrow) and a "soap-bubbly appearance to the meconium (white oval). In the contrast enema on the right, a small, unused microcolon (white arrows) is seen and there are filling defects representing meconium pellets in the terminal ileum and colon (black arrow).
Figure 4 :Microcolon in meconiumileus and ilealatresia. Contrast enema of the same infant shows the microcolon. There is small bowel dilatation in the right abdomen pushing the colon medially. This is not an uncommon appearance in neonatal distal bowel obstruction. This child has meconiumileus.
Prueba del sudor
An axial contrast-enhanced CT scan shows a blind-ending thickened bowel loop owing to inflamed diverticulum (Fig. 1). More inferiorly is a
Figure 2 :Uncomplicated meconiumileus. Pathology specimen of a neonate with arrows on meconium within the dilated terminal ileum.
Figure 4 :Ultrasound appearance of meconiumileus.Echogenicmeconium (M) fills the dilated bowel loop (arrow).
Figure 1 :Meconiumileus. Air-filled, dilated bowel loops are present throughout the abdomen. Multiple loops of meconium-filled gut are seen above the distal meconium impaction.