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Meconium Plug Syndrome

(Small Left Colon Syndrome)


William J. Cochran

, MD, Geisinger Clinic

Last full review/revision Aug 2021| Content last modified Aug 2021

Meconium plug syndrome is blockage of the large intestine with thick intestinal contents (meconium).

  • Meconium plug syndrome may result from Hirschsprung disease or cystic fibrosis.

  • Typically, newborns have feeding problems, vomit, have an enlarged abdomen, and do not have a bowel movement during the first day or two of life.

  • The diagnosis is based on symptoms and x-ray results.

  • The blockage is treated with enemas and sometimes surgery.

Meconium, a dark green material, is a newborn's first stool. Newborns expel meconium at or shortly after birth. If the meconium is abnormally thick or tarlike, it can block the large intestine (colon). In meconium plug syndrome, the colon is completely blocked with thick meconium. Above the blockage, the small intestine is enlarged (dilated) resulting in abdominal swelling (distention).

Symptoms of Meconium Plug Syndrome

After birth, newborns usually pass meconium in the first 12 to 24 hours. However, newborns with meconium plug syndrome do not pass meconium within the first day or two and also have symptoms of intestinal blockage, including vomiting and abdominal swelling. Doctors may feel enlarged loops of small bowel through the abdominal wall.

Diagnosis of Meconium Plug Syndrome

  • Plain x-rays of the abdomen

  • Radiopaque contrast enema

  • Sometimes testing for Hirschsprung disease

Doctors suspect meconium plug syndrome in newborns who have symptoms of blockage and do not pass meconium within the first day or two. Plain x-rays of the abdomen may show intestinal obstruction. To make a definitive diagnosis, doctors take x-rays after giving an enema using a liquid substance that is visible on x-rays (radiopaque contrast agent X-rays with a radiopaque contrast agent X-rays are high-energy radiation waves that can penetrate most substances (to varying degrees). In very low doses, x-rays are used to produce images that help doctors diagnose disease. In high... read more ). The contrast agent outlines the inside of the colon and allows doctors to see the meconium plug.

Treatment of Meconium Plug Syndrome

  • Radiopaque contrast enema

  • Rarely surgery

The radiopaque contrast enema is used to help diagnose and treat meconium plug syndrome. The contrast liquid helps bring fluid into the colon and break off the meconium so that the infant can then pass the meconium.

If the enema does not remove the plug, doctors may remove it surgically.

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Frequent doctor visits are recommended for all infants younger than 1 year of age. These visits, also called well-child visits, make it possible to check development, look for health problems, provide age-appropriate vaccinations, and educate parents. Which of the following is a condition that might affect some infants born very prematurely, with less than 32 weeks of development in the uterus?
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