Which newborn condition presents with abdominal distension and failure to pass meconium, commonly associated with cystic fibrosis?

• A. Hirschsprung disease.
• B. Meconium ileus (often associated with cystic fibrosis).
• C. Pyloric stenosis.
• D. Gastroschisis.

Answer: (B)

The situation points to a newborn bowel obstruction at the level of the distal ileum. Meconium ileus is the condition most closely tied to cystic fibrosis, where thick, sticky meconium plugs the ileum right after birth. This blockage leads to abdominal distension and failure to pass meconium in the first days of life, which is a classic CF-associated presentation.

Other conditions can cause abdominal distension or delayed meconium, but their typical features aren’t as strongly linked to CF: Hirschsprung disease involves lack of intestinal nerves leading to obstruction but isn’t defined by a CF association; pyloric stenosis presents with early nonbilious projectile vomiting and a palpable olive, not usually failure to pass meconium; gastroschisis is an abdominal wall defect with exposed bowel and stool passage isn’t the primary issue.