eMedicine Specialties > Radiology > Pediatrics

Ileal Atresia: Multimedia

Author: Ricardo Riego de Dios, MD, Staff Physician, Department of Diagnostic Radiology, Naval Hospital Jacksonville, Naval Air Station
Coauthor(s): Ellen M Chung, MD, Chief, Pediatric Radiology Section, Department of Radiologic Pathology, Armed Forces Institute of Pathology
Contributor Information and Disclosures

Updated: Feb 25, 2009

Multimedia

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Media file 1: Ileal atresia occurs in 4 main types with subtypes. Type I is characterized by a thin diaphragm that occludes the lumen. In type II, 2 blind ends are connected with a fibrous cord of atretic bowel. In type IIIA, 2 blind ends terminate with a V-shaped mesenteric defect; this is the most common type. Type IIIB, apple-peel or Christmas-tree atresia, involves a large, V-shaped mesenteric defect in which the blind-ended bowel distal to the atresia is wrapped around its collateral blood supply. Type IV is defined as multiple atresias.

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Ileal atresia occurs in 4 main types with subtypes. Type I is characterized by a thin diaphragm that occludes the lumen. In type II, 2 blind ends are connected with a fibrous cord of atretic bowel. In type IIIA, 2 blind ends terminate with a V-shaped mesenteric defect; this is the most common type. Type IIIB, apple-peel or Christmas-tree atresia, involves a large, V-shaped mesenteric defect in which the blind-ended bowel distal to the atresia is wrapped around its collateral blood supply. Type IV is defined as multiple atresias.

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Media file 2: Ileal atresia. Upright radiograph of the abdomen demonstrates many dilated loops of bowel and air-fluid levels.

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Ileal atresia. Upright radiograph of the abdomen demonstrates many dilated loops of bowel and air-fluid levels.

Ileal atresia. Same patient as in <a href="#Multi...

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Media file 3: Ileal atresia. Same patient as in Image 2 in Multimedia. Contrast enema study demonstrates microcolon with abrupt cut-off of contrast material filling of the ileum. Image shows no filling of dilated bowel proximal to the obstruction and a lack of filling defects in the small bowel.

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Ileal atresia. Same patient as in Image 2 in Multimedia. Contrast enema study demonstrates microcolon with abrupt cut-off of contrast material filling of the ileum. Image shows no filling of dilated bowel proximal to the obstruction and a lack of filling defects in the small bowel.

(Enlarge Image)

Media file 4: Ileal atresia. Contrast enema study demonstrates a small, unused colon with abrupt truncation of the column of contrast agent in the distal ileum.

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Ileal atresia. Contrast enema study demonstrates a small, unused colon with abrupt truncation of the column of contrast agent in the distal ileum.

(Enlarge Image)

Media file 5: Meconium ileus. Main differential consideration. Plain radiograph of the abdomen demonstrates dilated loops of bowel with no rectal air and with a soap-bubble appearance in the right lower quadrant.

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Meconium ileus. Main differential consideration. Plain radiograph of the abdomen demonstrates dilated loops of bowel with no rectal air and with a soap-bubble appearance in the right lower quadrant.

(Enlarge Image)

Media file 6: Cystic meconium peritonitis. Plain radiograph of the abdomen shows multiple air-filled loops of bowel, some dilated, and a large, rounded structure with calcified wall in the mid abdomen.

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Cystic meconium peritonitis. Plain radiograph of the abdomen shows multiple air-filled loops of bowel, some dilated, and a large, rounded structure with calcified wall in the mid abdomen.

Meconium ileus. Same patient as in <a href="#Mult...

(Enlarge Image)

Media file 7: Meconium ileus. Same patient as in Image 5 in Multimedia. Contrast enema study demonstrates microcolon with reflux of contrast agent into small bowel of a caliber similar to that of the colon. Round, tubular filling defects that represent inspissated meconium are demonstrated in the small bowel.

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Meconium ileus. Same patient as in Image 5 in Multimedia. Contrast enema study demonstrates microcolon with reflux of contrast agent into small bowel of a caliber similar to that of the colon. Round, tubular filling defects that represent inspissated meconium are demonstrated in the small bowel.

(Enlarge Image)

Media file 8: Cystic meconium peritonitis. Same patient as in Image 7 in Multimedia. Sonogram shows rounded, echogenic near-surface and posterior acoustic shadowing. Distal ileal perforation was discovered at surgery.

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Cystic meconium peritonitis. Same patient as in Image 7 in Multimedia. Sonogram shows rounded, echogenic near-surface and posterior acoustic shadowing. Distal ileal perforation was discovered at surgery.

More on Ileal Atresia

Overview: Ileal Atresia

Imaging: Ileal Atresia

Follow-up: Ileal Atresia

Multimedia: Ileal Atresia

References

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Hernanz-Schulman M. Imaging of neonatal gastrointestinal obstruction. Radiol Clin North Am. Nov 1999;37(6):1163-86, vi-vii. [Medline].
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Walker WA. Congenital anomalies. In: Walker WA, Hamilton JR, Watkins JB, Durie PR, Walker-Smith JA, eds. Pediatric gastrointestinal disease. 3rd ed. London: BC Decker;. 2000: 556-61.
Okada PJ, Hicks B. Neonatal surgical emergencies. Clin Peditr Emerg Med. 2002;3(1):3-13.
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Stringer DA, Babyn PS. Congenital and developmental anomalies of the small bowel. In: Stringer DA, Babyn PS. Pediatric Gastrointestinal Imaging. 2nd ed. London: BC Decker;. 2000: 338-42.
Piper HG, Alesbury J, Waterford SD, Zurakowski D, Jaksic T. Intestinal atresias: factors affecting clinical outcomes. J Pediatr Surg. Jul 2008;43(7):1244-8. [Medline].
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Neal MR, Seibert JJ, Vanderzalm T, Wagner CW. Neonatal ultrasonography to distinguish between meconium ileus and ileal atresia. J Ultrasound Med. Apr 1997;16(4):263-6; quiz 267-8. [Medline].
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Berrocal T, Lamas M, GutiÃ©rrez J, et al. Congenital anomalies of the small intestine, colon, and rectum. Radiographics. Sep-Oct 1999;19(5):1219-36. [Medline].
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Carty H, Brereton RJ. The distended neonate. Clin Radiol. Jul 1983;34(4):367-80. [Medline].
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Keywords

ileal atresia, atresia of the ileum, neonatal intestinal obstruction, ileal stenosis, small intestine atresia, small intestine stenosis, atresia of the small intestine, stenosis of the small intestine, jejunal atresia, small bowel atresia, small bowel stenosis, small-bowel atresia, small-bowel stenosis, meconium peritonitis, apple peel atresia, apple-peel atresia, Christmas tree atresia, Christmas-tree atresia

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Contributor Information and Disclosures

Author

Ricardo Riego de Dios, MD, Staff Physician, Department of Diagnostic Radiology, Naval Hospital Jacksonville, Naval Air Station
Ricardo Riego de Dios, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Phi Beta Kappa, and Radiological Society of North America
Disclosure: Nothing to disclose.

Coauthor(s)

Ellen M Chung, MD, Chief, Pediatric Radiology Section, Department of Radiologic Pathology, Armed Forces Institute of Pathology
Ellen M Chung, MD is a member of the following medical societies: American Association for Women Radiologists, American College of Radiology, American Medical Association, American Roentgen Ray Society, Radiological Society of North America, and Society for Pediatric Radiology
Disclosure: Nothing to disclose.

Medical Editor

Lori Lee Barr, MD, FACR, FAIUM, Clinical Associate Professor of Radiology, University of Texas Health Science Center in San Antonio; Clinical Assistant Professor of Radiology, University of Texas Medical Branch at Galveston; Member, Board of Directors, Austin Radiological Association; Consulting Staff, Seton Health Network, Columbia/St David's Healthcare System, Healthsouth Rehabilitation Hospital of Austin, Georgetown Hospital, St Mark's Medical Center, Cedar Park Regional Medical Center
Lori Lee Barr, MD, FACR, FAIUM is a member of the following medical societies: American Association for Women Radiologists, American College of Radiology, American Institute of Ultrasound in Medicine, American Roentgen Ray Society, American Society of Pediatric Neuroradiology, Association of University Radiologists, Radiological Society of North America, Society for Pediatric Radiology, Society of Radiologists in Ultrasound, Southern Medical Association, Texas Radiological Society, and Undersea and Hyperbaric Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

David A Stringer, BSc, MBBS, FRCR, FRCPC, Professor, National University of Singapore; Head, Diagnostic Imaging, KK Women's and Children's Hospital, Singapore
David A Stringer, BSc, MBBS, FRCR, FRCPC is a member of the following medical societies: British Columbia Medical Association, Canadian Association of Radiologists, European Society of Paediatric Radiology, Ontario Medical Association, Radiological Society of North America, Royal College of Physicians and Surgeons of Canada, Royal College of Radiologists, and Society for Pediatric Radiology
Disclosure: Sirius d'innovation None Board membership

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

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eMedicine Specialties > Radiology > Pediatrics

Ileal Atresia: Multimedia

Multimedia

Ileal atresia. Upright radiograph of the abdomen demonstrates many dilated loops of bowel and air-fluid levels.

Ileal atresia. Same patient as in Image 2 in Multimedia. Contrast enema study demonstrates microcolon with abrupt cut-off of contrast material filling of the ileum. Image shows no filling of dilated bowel proximal to the obstruction and a lack of filling defects in the small bowel.

Ileal atresia. Contrast enema study demonstrates a small, unused colon with abrupt truncation of the column of contrast agent in the distal ileum.

Meconium ileus. Main differential consideration. Plain radiograph of the abdomen demonstrates dilated loops of bowel with no rectal air and with a soap-bubble appearance in the right lower quadrant.

Cystic meconium peritonitis. Plain radiograph of the abdomen shows multiple air-filled loops of bowel, some dilated, and a large, rounded structure with calcified wall in the mid abdomen.

Meconium ileus. Same patient as in Image 5 in Multimedia. Contrast enema study demonstrates microcolon with reflux of contrast agent into small bowel of a caliber similar to that of the colon. Round, tubular filling defects that represent inspissated meconium are demonstrated in the small bowel.

Cystic meconium peritonitis. Same patient as in Image 7 in Multimedia. Sonogram shows rounded, echogenic near-surface and posterior acoustic shadowing. Distal ileal perforation was discovered at surgery.

More on Ileal Atresia

References

Further Reading

Keywords

Contributor Information and Disclosures

Author

Coauthor(s)

Medical Editor

Pharmacy Editor

Managing Editor

CME Editor

Chief Editor