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November 1990

Radiological Case of the Month

Author Affiliations

Contributed from the Department of Surgery, Division of Pediatric Surgery, King Fahd Hospital of the University, Al-Khobar, Saudi Arabia.

Am J Dis Child. 1990;144(11):1273-1274. doi:10.1001/archpedi.1990.02150350105036

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