MECONIUM PLUG SYNDROME IN THE NEWBORN
Category: Child Health
Abstract : meconium plug syndrome in the newborn : Some newborns present with bowel
obstruction from plugs of meconium isolated to the colon. Most of these newborns
are otherwise healthy babies, but all should undergo a contrast enema, which
almost always is diagnostic (no pathology) as well as therapeutic (successful in
loosening the meconium plug and resolving the obstruction). A plug of meconiu
meconium plug syndrome in the newborn :
Some newborns present with bowel
obstruction from plugs of meconium isolated to the colon. Most of these newborns
are otherwise healthy babies, but all should undergo a contrast enema, which
almost always is diagnostic (no pathology) as well as therapeutic (successful in
loosening the meconium plug and resolving the obstruction).
A plug of meconium
isolated to the colon is usually unrelated to cystic fibrosis.
Conditions
that predispose to dysmotility of the neonatal bowel, such as maternal
preeclampsia, maternal diabetes mellitus, maternal administration of magnesium
sulfate, prematurity, sepsis, and hypothyroidism, may be responsible for the
formation of the meconium plug. In each of these conditions, the colon distal to
the obstruction is narrowed and small in caliber.
Because of the frequent
association between maternal diabetes mellitus and colonic obstruction with a
small left colon, this association is termed small left colon syndrome. As with
meconium ileus, a nonoperative approach with administration of enemas is favored
to relieve the obstruction. The enemas can also serve to dilate the
small-caliber distal colon.
A need for laparotomy to evacuate the
meconium suggests a diagnosis other than simple meconium plug syndrome.
Hirschsprung disease can be associated with meconium plug syndrome in 4% of
patients; therefore, a suction rectal biopsy may be indicated.
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