A 3200-g female newborn was admitted to the hospital at 2 days of age. She was the product of a full-term normal pregnancy and spontaneous vaginal delivery to a diabetic mother. The patient was admitted to the hospital because of bilious vomiting, failure to pass meconium, and progressive abdominal distention.
The physical examination demonstrated abdominal distention but no palpable masses or organomegaly. The infant was hypoglycemic, with a blood glucose level of 2.4 mmol/L. The remainder of the laboratory data were normal. A roentgenogram of the abdomen was obtained (Fig 1). A contrast enema using dilute meglumine diatrizoate (Gastrografin) was performed (Fig 2).
Denouement and Discussion
Neonatal Small Left Colon Syndrome
Following the administration of the Gastrografin enema, the infant began to pass small amounts of meconium. Hypoglycemia was treated and after a repeated Gastrografin enema, the infant passed meconium freely and the abdominal distention subsided. The patient was discharged
Al-Salem AH, Khwaja S, Wood BP. Radiological Case of the Month. Am J Dis Child. 1990;144(11):1273-1274. doi:10.1001/archpedi.1990.02150350105036