Question:

What imaging findings are commonly seen in ileal atresia?
1. Dilated loops of bowel
2. Abdominal calcifications
3. Meconium pseudocyst
4. Distension of the colon
5. Microcolon





Answer:

The correct answers for the question "What imaging findings are commonly seen in ileal atresia?" are:

1. Dilated loops of bowel

2. Abdominal calcifications

3. Meconium pseudocyst

5. Microcolon



Explanation
1. Dilated bowel loops proximal to the site of obstruction are a hallmark finding in ileal atresia. (Dilated air filled loops of small bowel are noted as well, consistent with small bowel obstruction.)

2. Abdominal calcifications will be seen in the setting of ileal atresia with perforation and meconium peritonitis.  (Meconium peritonitis may be diagnosed prenatally by the presence of peritoneal fluid collections, which can loculate and calcify (4).)

3. Meconium pseudocyst may be seen in ileal atresia with perforation and resultant meconium peritonitis that loculates into a fluid collection. (The constellation of a perihepatic collection and dilated bowel loops suggested the diagnosis of ileal atresia with perforation.)

4. Microcolon, rather than distension of the colon is seen in the case of ileal obstruction because of proximal blockage at the atretic site.  (Contrast enema demonstrates a normal sized rectum but microcolon of the sigmoid and remaining colon.)

5. Microcolon is seen in ileal atresia because of functional disuse of the colon distal to the site of obstruction.  (The dilated bowel loops are present proximal to the atretic site and microcolon is often noted distal to the site of obstruction.)



From the manuscript:
Ileal Atresia with Meconium Peritonitis: Fetal MRI Evaluation
Radiology Case. 2010 Mar; 4(3):15-18


This article belongs to the Pediatric section.




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From the manuscript

Ileal Atresia with Meconium Peritonitis: Fetal MRI Evaluation

Free full text article: Ileal Atresia with Meconium Peritonitis: Fetal MRI Evaluation

Abstract
We report a case of ileal atresia with meconium peritonitis evaluated by fetal MRI. Prenatal ultrasounds in the third trimester initially demonstrated a cystic abdominal mass that resolved with development of dilated bowel loops. Fetal MRI at 32 weeks gestation identified a perihepatic collection with several dilated small bowel loops and normal sized meconium filled rectosigmoid consistent with distal bowel perforation and loculated meconium peritonitis. Following delivery, the infant presented with bowel obstruction. Contrast enema revealed a normal sized rectosigmoid with small ascending and transverse colon. A distal ileal atresia type IIIa was documented at surgery.






References



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