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

(3) prematurity

(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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