MECONIUM PLUG SYNDROME: A CAUSE OF NEONATAL INTESTINAL OBSTRUCTION

¹ From the Departments of Radiology and Pediatrics, University of Oklahoma Medical Center, Oklahoma City, Oklahoma

Three cases of meconium plug syndrome recently seen at our hospital are reported. The clinical picture is that of a low small bowel obstruction in the neonatal period. A barium enema examination should be performed as soon as the obstruction is suspected, as it will usually lead to the correct diagnosis. The enema findings are characteristic and will in most cases exclude meconium ileus or ileal atresia. One cannot, however, always exclude Hirschsprung's disease nor congenital colonic stenosis on this basis and close follow-up of the patient is therefore required.

Various etiologic factors are reviewed and it is noted that the syndrome is particularly prone to develop in premature infants and infants with underlying cerebral insult. It is postulated that because of generalized muscular weakness and colon immaturity these infants are unable to spontaneously dislodge the meconium plug. With retention of the plug, obstruction results and the full syndrome develops.

The meconium plug syndrome should always be considered in the differential diagnosis of low small bowel or colonic obstruction in the newborn infant, as prompt diagnosis and adequate medical treatment will in most cases completely resolve the problem and avoid an unnecessary surgical procedure.

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