Intraluminal Intestinal Calcification in the Newborn

Abstract

Meconium ileus is now a well recognized entity and I do not need to dwell upon it in this paper. It is not only the condition in which an abnormality of the intestinal contents causes obstruction in the neonatal period. In recent years more attention has been paid to meconium plugs as a cause of blockage (Clatworthy, Howard and Lloyd, 1956). The object of this paper is to draw attention to a third condition causing intraluminal obstruction in early infancy. I apologize for reporting a single case. The con-dition seems to be extremely rare; at any rate I have found very few pertinent references in the course of a careful search through the literature. I wonder, however, whether an increased interest in this syndrome may not result in further cases being reported, as has happened before with many other diseases which were originally thought to be rarities. I apologize also for not being able to throw any light upon the causation of this lesion. In spite of a large volume of clinical and biochemical investigation carried out upon this particular infant, the disease remains surrounded by mystery. Any light shed on the little understood physiology of the neonatal intestinal tract is of value and this is a further reason for the publication of this case. Case History Gillian was admitted to the Alder Hey Neonatal Surgical Unit on August 25, 1955, when 37 hours old, a one-month premature infant weighing 5 lb. She was the first child of parents both of whom had been treated for infertility for several years. The infant had vomited repeatedly since birth and the vomitus had become bile-stained; she had not passed any meconium. On admission her general condition was fair. There was some abdominal distension and a radiograph in the upright position showed numerous fluid levels. On the right side of the abdomen a number of calcified, worm-like-shadows could be seen (Fig. 1). In view of the clinical and radiological findings a provisional diagnosis of low small bowel obstruction associated with meconium peritonitis was made and she was operated upon two hours after admission. At laparotomy the jejunum and * A paper read at the meeting of the British Association of