Meconium ileus is associated with CF and occurs when?

• A. Duodenal atresia
• B. Hirschsprung disease
• C. Intussusception
• D. Meconium ileus at birth

Answer: (D)

Meconium ileus is the newborn manifestation of cystic fibrosis where thick, inspissated meconium blocks the terminal ileum. The CFTR defect leads to dehydrated, viscous intestinal secretions, so meconium sticks and plugs the distal small bowel. This typically presents in the neonatal period, often within the first day or two after birth, with failure to pass meconium, abdominal distension, and sometimes bilious vomiting. Radiographs can show dilated bowel loops with a soap-bubble appearance from gas trapped around the thick meconium. Because this obstruction originates in the newborn due to CF, it is described as occurring at birth in CF patients. Other neonatal GI obstructions exist, but they are not characteristically linked to CF or to birth-era presentation.