Neonatal small left colon

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a.k.a Meconium plug syndrome, Functional immaturity of the colon

Uncommon cause of neonatal intestinal obstruction characterized by an abrupt intestinal caliber transition at or near the splenic flexure and and normal rectum. Half of cases associated with a maternal history of gestational diabetes mellitus. No association with Cystic fibrosis. Diagnosis is not definitive until Hirschsprung disease has been excluded by biopsy.

Contrast enema is both diagnostic and therapeutic. Patients with small left colon will improve quickly and their colon will normalize within weeks.

Clinical Presentation

  • Patients do not pass meconium within the first 24 hours of life.
  • All develop abdominal distension with bilious vomiting or nasogastric aspirates.

See Also