Enema for low obstruction in premature infant done portably

  • Patient preparation: none
  • Contrast used: high osmolar water soluble, dilute contrast using 1 part contrast : 2 parts sodium chloride if < 1 year old or 2 parts tap water if > 1 year old
  • Technique: red rubber catheter, tape tip in securely, pinch buttocks while injecting contrast, use gentle hand injection to instill 5-10 cc contrast in supine position, consider injecting another 5-10 cc of contrast in order to opacify the entire colon with contrast and reflux the terminal ileum
  • Images to obtain: scout AP abdomen, AP and lateral abdomen after initial 5-10 cc of contrast, AP and lateral abdomen after additional 5-10 cc of contrast if needed
  • Looking for: meconium obstruction of prematurity (most commonly), meconium ileus, meconium plug, ileal atresia, colon atresia, Hirschsprung disease
  • Post procedure tasks: if meconium obstruction of prematurity or meconium ileus is encountered, perform enema for reduction of meconium ileus