Meconium plug syndrome: Difference between revisions
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Meconium plug syndrome must be differentiated from other diseases that cause a failure to pass [[meconium]] or [[abdominal distension]] in infants, including [[small left colon syndrome]], and [[congenital hypothyroidism]]. | |||
{| class="wikitable" | |||
!Disease | |||
!Prominent clinical features | |||
!Radiological findings | |||
|- | |||
|[[Meconium plug syndrome]] | |||
| | |||
* Transient [[intestinal obstruction]] for 1-2 days after birth. | |||
* Obstruction is functional due to dilated colon and delayed passage of feces. | |||
* Usually seen in [[premature infants]].<ref name="pmid18485962">{{cite journal |vauthors=Keckler SJ, St Peter SD, Spilde TL, Tsao K, Ostlie DJ, Holcomb GW, Snyder CL |title=Current significance of meconium plug syndrome |journal=J. Pediatr. Surg. |volume=43 |issue=5 |pages=896–8 |year=2008 |pmid=18485962 |pmc=3086204 |doi=10.1016/j.jpedsurg.2007.12.035 |url=}}</ref> | |||
|[[Image:Meconium-plug-syndrome - Case courtesy of Radswiki, Radiopaedia.org, rID 11606.jpg|center|300px|thumb|Abdominal x-ray with contrast showing inspissated meconium in the intestine, proximal to the colon - Case courtesy of Radswiki, Radiopaedia.org, rID 11606]] | |||
|- | |||
|[[Small left colon syndrome]] | |||
| | |||
* Reduced caliber of the [[colon]] starting from [[splenic flexure]] and going down, causing [[intestinal obstruction]]. | |||
* Characterized by a sudden change of the colon diameter. | |||
* Usually associated with [[gestational diabetes]].<ref name="pmid910057">{{cite journal |vauthors=Berdon WE, Slovis TL, Campbell JB, Baker DH, Haller JO |title=Neonatal small left colon syndrome: its relationship with aganglionosis and meconium plug syndrome |journal=Radiology |volume=125 |issue=2 |pages=457–62 |year=1977 |pmid=910057 |doi=10.1148/125.2.457 |url=}}</ref> | |||
|[[Image:Small-left-colon-syndrome-1 - Case courtesy of Dr Eric F Greif, Radiopaedia.org, rID 30024.jpg|center|300px|thumb|Abdominal x-ray with contrast, shows decreased caliber of the descending and sigmoid colon, loss of haustration along with filling defects corresponding to retained feces - Case courtesy of Dr Eric F Greif, Radiopaedia.org, rID 30024]] | |||
|- | |||
|[[Intestinal atresia|Distal small intestine/colon atresia]] | |||
| | |||
* Failure to pass [[meconium]] due to failure of intestine recanalization. | |||
* Proximal [[lesions]] have an earlier onset of symptoms than distal [[lesions]]. | |||
* [[Intestinal atresia|Colonic atresia]] may affect normal children or may be associated with other abnormalities as Hirschsprung's disease or [[gastroschisis]].<ref name="pmid17077911">{{cite journal |vauthors=Spitz L |title=Observations on the origin of congenital intestinal atresia |journal=S. Afr. Med. J. |volume=96 |issue=9 Pt 2 |pages=864 |year=2006 |pmid=17077911 |doi= |url=}}</ref> | |||
|[[Image:Small-bowel-atresia - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID 5959.jpg|center|300px|thumb|Normal appearing colon that is small and unused. Contrast fills the whole colon and passes to the ileum - Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID 5959]] | |||
|- | |||
|[[Meconium ileus]] | |||
| | |||
* [[Intestinal obstruction]] due to inspissation of [[meconium]] in the [[Ileum|distal ileum]]. | |||
* Most cases of [[meconium ileus]] are secondary to [[cystic fibrosis]]. | |||
* Typically presents with failure to pass [[meconium]] and [[abdominal distension]] with or without [[vomiting]]. | |||
* [[Meconium ileus]] may first present with complications, including [[perforation]] and [[volvulus]].<ref name="pmid14237408">{{cite journal |vauthors=HOLSCLAW DS, ECKSTEIN HB, NIXON HH |title=MECONIUM ILEUS. A 20-YEAR REVIEW OF 109 CASES |journal=Am. J. Dis. Child. |volume=109 |issue= |pages=101–13 |year=1965 |pmid=14237408 |doi= |url=}}</ref> | |||
|[[Image:Meconium-ileus-neonate-with-cystic-fibrosis - Case courtesy of Dr Michael Sargent, Radiopaedia.org, rID 6009.jpg|center|300px|thumb|Contrast enema shows inspissated meconium starting from the mid-sigmoid colon and going up till the splenic flexure. The colon is normal in diameter, ruling out microcolon - Case courtesy of Dr Michael Sargent, Radiopaedia.org, rID 6009]] | |||
|- | |||
|[[Congenital hypothyroidism]] | |||
| | |||
*Most infants are born [[asymptomatic]].<ref name="pmid2295961">{{cite journal |vauthors= |title=Elementary school performance of children with congenital hypothyroidism. New England Congenital Hypothyroidism Collaborative |journal=J. Pediatr. |volume=116 |issue=1 |pages=27–32 |year=1990 |pmid=2295961 |doi= |url=}}</ref> | |||
*Symptoms, if present, may include, but not limited to: | |||
**[[Macroglossia]] | |||
**Hoarse cry | |||
**[[Umbilical hernia]] | |||
**Puffy facies | |||
**Increased head circumference | |||
**[[Hypothermia]] | |||
| | |||
|} | |||
==References== | ==References== | ||
Latest revision as of 16:20, 29 August 2017
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Meconium plug syndrome must be differentiated from other diseases that cause a failure to pass meconium or abdominal distension in infants, including small left colon syndrome, and congenital hypothyroidism.
| Disease | Prominent clinical features | Radiological findings |
|---|---|---|
| Meconium plug syndrome |
|
 |
| Small left colon syndrome |
|
 |
| Distal small intestine/colon atresia |
|
 |
| Meconium ileus |
|
 |
| Congenital hypothyroidism |
|
References
- ↑ Keckler SJ, St Peter SD, Spilde TL, Tsao K, Ostlie DJ, Holcomb GW, Snyder CL (2008). "Current significance of meconium plug syndrome". J. Pediatr. Surg. 43 (5): 896–8. doi:10.1016/j.jpedsurg.2007.12.035. PMC 3086204. PMID 18485962.
- ↑ Berdon WE, Slovis TL, Campbell JB, Baker DH, Haller JO (1977). "Neonatal small left colon syndrome: its relationship with aganglionosis and meconium plug syndrome". Radiology. 125 (2): 457–62. doi:10.1148/125.2.457. PMID 910057.
- ↑ Spitz L (2006). "Observations on the origin of congenital intestinal atresia". S. Afr. Med. J. 96 (9 Pt 2): 864. PMID 17077911.
- ↑ HOLSCLAW DS, ECKSTEIN HB, NIXON HH (1965). "MECONIUM ILEUS. A 20-YEAR REVIEW OF 109 CASES". Am. J. Dis. Child. 109: 101–13. PMID 14237408.
- ↑ "Elementary school performance of children with congenital hypothyroidism. New England Congenital Hypothyroidism Collaborative". J. Pediatr. 116 (1): 27–32. 1990. PMID 2295961.