OnlineMedEd: Pediatrics - "Failure to Pass Meconium"

Question 1

Failure to pass meconium is defined as _______________.

Answer 1

no passage of stool for the first 48 hours of life

Question 2

Any disease in which ______________ can cause failure to pass meconium.

Answer 2

the bowels are obstructed (e.g., biliary atresia, bowel necrosis, annular pancreas)

Question 3

Recall that Hirschprung’s can present ______________.

Answer 3

later in life (around age 2) with chronic diarrhea around the impaction

Question 4

Imperforate anus is part of a syndrome: _____________.

Answer 4

VACTERL

• Vertebral anomalies
• Anus anomalies
• Cardiac defects
• Tracheal-Egsophageal fistulas
• Renal problems
• Limb deformities

Because of this, you should do a sacral US, echocardiography, VCUR, wrist x-ray, and x-ray with a catheter in a child with imperforate anus.

Question 5

Talk about the two grades of severity of imperforate anus and how they are treated.

Answer 5

• Mild (anus near rectum): fix immediately

* Severe (anus far from rectum): colostomy now, fix once child has grown and there is more anus to work with

Question 6

Meconium ileus is treatable with _____________.

Answer 6

water enema

Question 7

On an x-ray of a person with Hirschprung’s, the good colon looks ______________.

Answer 7

dilated; the bad colon looks normal because it is constricted

Question 8

Those with ___________ are at higher risk of retentive encopresis.

Answer 8

cognitive impairment