The meconium plug syndrome is a common cause of neonatal intestinal obstruction with a failure to pass meconium. It may occur by itself or it may occur in conjunction with other bowel disorders.
Clinical and radiologic findings:
(1) neonate with evidence of bowel obstruction
(1a) failure to pass meconium
(1b) abdominal distention
(1c) bilious vomiting
(2) distended colon with an obstructing filling defect
(3) a diagnostic enema results in passage of a solid plug of inspissated meconium
(4) if no other process is present then colon function is normal afterwards
Risk factors for meconium plug formation:
(1) cystic fibrosis
(2) Hirschsprung's disease or a related disorder
(4) maternal treatment with magnesium sulfate
Any neonate with a meconium plug should be tested for cystic fibrosis and Hirschsprung's disease.
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