Hydrostatic Enema Under Ultrasonic Guidance for Meconium Related Ileus in Extremely Low Birth Weight Infants

Abstract

A female extremely low birth weight (ELBW) infant presented with meconium related ileus (MRI) on her first day of life. We attempted a hydrostatic enema under ultrasonic guidance. The procedure was performed while the infant remained in an incubator. Four-fold attenuation of iopamidol was injected into her colon with 50 cmH_2O static pressure, and an ultrasonic imaging was performed concurrently. The imaging showed that the contrast media reached the ileum and advanced beyond the meconium plug. A roentgenogram showed the same appearance. The intestinal obstruction was reduced about 6 hours after the procedure. Ultrasonic imaging is useful for hydrostatic enema treatment for MRI in ELBW infants.