Diagnosing ileal atresia: the role of clinical correlation and plain radiography

Abstract

Ileal atresia is a subset of congenital gastrointestinal malformations that result in neonatal bowel obstruction. We report a case of a 7-day old male neonate who presented with failure to pass meconium, abdominal distension and late onset bilious vomiting. A plain abdominal radiograph revealed dilated bowel loops with fluid levels of different sizes, the largest appearing as a fluid filled mass with an abrupt cut off. These findings were consistent with ileal atresia and the diagnosis was confirmed intra-operatively. This case description is aimed at emphasizing the role of clinical correlation and a plain abdominal radiograph in the diagnosis of ileal atresia which are two important modalities that have imaging modalities which delay management. The  diagnosis of ileal atresia can be suspected in the neonate who presents with failure to pass meconium, abdominal distension, late onset bilious vomiting and a plain abdominal radiograph with fluid levels of different sizes, the largest situated just proximal to the atretic zone.

Keywords: Ileal atresia, plain radiograph, clinical assessment