Paediatric surgery: meconium ileus: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: meconium ileus

Sample item

A newborn has bilious vomiting, abdominal distension and failure to pass meconium. Abdominal film shows a ground-glass appearance with soap-bubble opacity. Which underlying disease should be sought?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Cystic fibrosis

Meconium ileus is obstruction of the terminal ileum by thick inspissated meconium and is almost pathognomonic of cystic fibrosis. Uncomplicated cases may be treated by a hyperosmolar water-soluble contrast enema, with surgery for complicated disease. Sweat chloride or genetic testing follows.

Option by option

  • A. Biliary atresia

    Biliary atresia presents with jaundice.

  • B. Hirschsprung disease

    Hirschsprung disease shows distal aganglionosis.

  • C. Duodenal atresia

    Duodenal atresia gives a double bubble sign.

  • D. Cystic fibrosis (correct)

    Correct. Meconium ileus is an early sign of cystic fibrosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Cystic fibrosis. Meconium ileus is obstruction of the terminal ileum by thick inspissated meconium and is almost pathognomonic of cystic fibrosis.

Why is "Biliary atresia" not the answer?

Biliary atresia presents with jaundice.

Why is "Hirschsprung disease" not the answer?

Hirschsprung disease shows distal aganglionosis.

Why is "Duodenal atresia" not the answer?

Duodenal atresia gives a double bubble sign.

What concept does this question test?

It tests Paediatric surgery: meconium ileus in General Surgery. Uncomplicated cases may be treated by a hyperosmolar water-soluble contrast enema, with surgery for complicated disease. Sweat chloride or genetic testing follows.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: meconium ileus?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.