Meconium plug syndrome
The meconium plug syndrome refers to a functional colonic obstruction in a newborn due to an obstructing meconium plug. It is usually transient and affects the left colon with meconium plugging the bowel distal to this segment. In this situation it is also termed the small left colon syndrome.
Associations
May have a higher prevalence with maternal diabetes 2.
Radiographic features
Plain film
May show multiple dilated bowel loops which is a non specific finding. There may be a calibre change around the splenic flexure.
Fluoroscopy / Contrast enema
May demonstrate a small calibre to the left colon with multiple filling defects within due to retained meconium. The enema can be both diagnostic as well as therapeutic and is usually accompanied by passage of meconium during the procedure.
Prognosis
Usually resolves with time
Differential diagnosis
On plain film consider
Most other causes of bowel obstruction
On contrast enema consider
- meconium ileus (right colon usually not dilated)
- long segment Hirschsprung disease (often has a reversed recto-sigmoid ratio)
- ileal atresia (on contrast enema)
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