Case report a term male infant with a birth weight of 3,300 gm was born by normal spontaneous vaginal delivery after an uncomplicated pregnancy to a 28yearold white woman. Infants with meconium plug present with delayed passage of meconium, abdominal distention, and perhaps vomiting cuenca et al. Following the passage of a meconium plug you baby may behave and feed entirely normally. Only one patient could be relieved of the ileal meconium plug by enemas. Pulling the plugmanagement of meconium plug syndrome in. In meconium plug syndrome, the colon is completely blocked with thick meconium.
Meconium plug syndrome neonatology diseases and disorders. Meconium plug syndrome, meconium ileus, and meconium ileus equivalent are conditions of gastrointestinal tract obstruction by thickened contents which will not pass. References 1 clatworthy jr hw, howard whr, lloyd j. Meconium ileus mi is often the first manifestation of cystic fibrosis cf and occurs in approximately 20% of patients diagnosed with cf.
Meconium plug syndrome symptoms, diagnosis, treatments and. Oral n acetyl cysteine for meconium ileus of preterm infants. Meconium aspiration syndrome genetic and rare diseases. We present a unique case of meconium plug syndrome associated with both cystic fibrosis and hirschsprungs disease. In meconium plug syndrome, there is meconium obstruction of the colon, often seen in infants of diabetic mothers or mothers who received magnesium sulfate for eclampsia.
Plain film diagnosis in meconium plug syndrome, meconium. Meconium plug syndrome definition of meconium plug syndrome. The condition of ileal meconium plug is not as benign as a meconium plug in the rectum or distal colon. It describes the spectrum of disorders and pathophysiology of newborns born in meconium stained amniotic fluid msaf and have meconium within their lungs. The clinical presentation of meconium plug syndrome and meconium ileus is similar, although the source of meconium obstruction is at 2 separate locations.
Meconium ileus is a neonatal condition characterized by a distal mechanical small bowel obstruction from thick viscous meconium. Neonates with suspected meconium ileus should be managed like any infant with intestinal obstruction. Meconium aspiration syndrome mas also known as neonatal aspiration of meconium is a medical condition affecting newborn infants. It is a transient form of distal colonic or rectal obstruction caused by hard, immobile meconium.
However your baby may have a swollen tummy because of a build up of meconium, wind and milk in the bowel. This diagnosis should be considered when an infant with meconiumplug obstruction of the colon fails to follow the usual satisfactory clinical course after the plug has been passed. Usually, it is benign and not associated with other intestinal dysfunction. Meconium plug syndrome definition of meconium plug. Infants with meconium plug present with delayed passage of meconium, abdominal. A condition that can occur in newborns where a mass of thickened meconium obstructs the large intestines. In our series, patients with typical meconium ileus appearing as ileal obstruction with proximal small bowel dilatation and microcolon were not included as meconium plug syndrome patients. Plain film diagnosis in meconium plug syndrome, meconium ileus. Meconium plug syndrome is a transient functional abnormality of the newborns digestive system which consists of the delayed passage of the meconium beyond 2448 hours, abdominal distension, vomiting, and dilatation of the left colon. The vomit will often be green due to the presence of bile. Meconium plug syndrome and meconium ileus springerlink. Meconium plug syndrome pediatrics msd manual professional.
Download fulltext pdf download fulltext pdf primary segmental volvulus of the ileum mimicking meconium plug syndrome article pdf available june 2011 with 98 reads. One study noted that 16% of cases of meconium plug syndrome were associated with magnesium tocolysis and only 3% were associated with hirschsprung disease. Meconium plug syndrome mps is a relatively benign cause of bowel obstruction in neonates in whom the passage of meconium is delayed during the first 2448 h of life. During the first day of life abdominal distention was noted and the infant had not passed any. Meconium plug syndrome must be differentiated from other diseases that cause a failure to pass meconium or abdominal distension in infants, including small. Meconium plug syndrome also termed functional immaturity of the colon, colonic immaturity, small left colon syndrome, and functional colonic obstruction is a transient disorder of the newborn colon characterized by delayed passage 2448 hr of meconium and intestinal dilatation. It describes the spectrum of disorders and pathophysiology of newborns born in meconiumstained amniotic fluid msaf and have meconium within their lungs. Meconium plug syndrome radiology reference article. Meconium aspiration syndrome mas is the aspiration of stained amniotic fluid, which can occur before, during, or immediately after birth. Meconium plug syndrome with aganglionosis american academy. Meconium plug syndrome is also associated with cystic fibrosis. Meconium aspirationmeconium aspirationsyndrome massyndrome masdr. Meconium ileus, meconium plug syndrome, and distal.
Meconium plug definition of meconium plug by medical dictionary. The meconium plug syndrome is a well recognized entityinability of the newborn to pass initial meconium by age 48 hours without. May, 2014 meconium plug syndrome, meconium ileus, and meconium ileus equivalent are conditions of gastrointestinal tract obstruction by thickened contents which will not pass. There has been much confusion regarding its relationship to meconium plug syndrome and aganglionosis. Mas can present with varying degrees of severity from mild respiratory distress to lifethreatening respiratory failure. Thick, inspissated, rubbery meconium forms a cast of the colon, resulting in complete obstruction. In this situation, it is also termed the small left colon syndrome. This can cause breathing difficulties due to swelling inflammation in the babys lungs after birth. These conditions are considered separately from functional or anatomic causes of neonatal intestinal obstruction, such as hirschsprung disease, intestinal atresia, and anorectal malformations. Ob viously the presence of this sign in mi was not necessarily a contraindication for treatment with contrast enema, as proposed before 7. Meconium obstruction of prematurity is an entity primarily affecting very low birthweight or extremely low birthweight babies causing low intestinal obstruction. Although mainly described in patients with cystic fibrosis cf, meconium ileus has also been described independent of cf. 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.
It is the most common form of functional bowel obstruction in the newborn, with an incidence of 1500 newborns. Mas can present with varying degrees of severity from mild respiratory distress to. Meconium ileus, meconium plug syndrome, and distal intestinal. Meconium ileus refers to a neonatal bowel obstruction of the distal ileum due to abnormally thick and impacted meconium. Meconium plug syndrome, intestinal obstruction, newborn. Meconium plug syndrome is the mildest and most common form of functional obstruction of the intestine in the newborn. Meconium plug syndrome was first reported by clatworthy in 1956, describing a syndrome of colonic obstruction because of inspissated meconium. Mar 20, 2017 meconium aspiration syndrome mas is the aspiration of stained amniotic fluid, which can occur before, during, or immediately after birth. Three cases of meconium plug syndrome recently seen at our hospital are reported. This contrasts to the intraluminal obstruction of the terminal ileum in meconium ileus. Neonatal small left colon syndrome is a cause of functional colon obstruction in newborn infants, with a high association of maternal diabetes. Plain film diagnosis in meconium plug syndrome, meconium ileus and neonatal hirschsprungs disease a scoring system s. If the meconium is abnormally thick or tarlike, it can block the large intestine colon.
That we had no patients with cystic fibrosis supports a theory that a meconium plug obstruction in the colon is a different disease entity than one located in the. Meconium aspiration syndrome mas is defined as respiratory distress in newborn infants born through meconium stained amniotic fluid msaf whose symptoms cannot be otherwise explained. Meconium plug syndrome merck manuals consumer version. The meconium plug syndrome roentgen evaluation and differentiation from hirschsprungs disease and other pathologic states trn he meconium plug syndrome isa relatively frequent cause of colonic mechanical obstruction in the newborn272527 and isrelated tothefailure to pass meconium inthe first days oflife. Meconium is the first intestinal discharge from newborns, a viscous, darkgreen substance composed of intestinal epithelial cells, lanugo, mucus, and intestinal secretions eg, bile.
The condition may occur as a result of other disorders such as cystic fibrosis, colon atresia, narrowed colon, impaired intestinal motility hirschsprung disease or for no apparent reason. The disease is diagnosed and treated by radiographic contrast enema, but hirschsprung disease and cystic fibrosis should be excluded. Meconium plugs find pediatric treatment, find doctors. Its presence may at best delay establishment of enteral feeding and compromise nutrition and at worst lead to mechanical obstruction requiring surgery or to intestinal perforation.
The incidence of meconium plug syndrome is estimated to range from one case in 500 to one case in 1,000 neonates. The meconium plug syndrome is a functional colonic obstruction in a newborn due to an obstructing meconium plug. A plea is made to restrict the name meconium plug syndrome to cases in which the meconium plug is white and chalky and the consequent intestinal obstruction can be relieved by enemas, without evidence of intestinal dysfunction in later life. Meconium plug syndrome is also called functional immaturity of the colon. It focuses on the medical and surgical management emphasizing the importance of nutrition and a multidisciplinary approach to improve both shortterm and longterm outcomes for. Treatments for meconium plug syndrome including drugs, prescription medications, alternative treatments, surgery, and lifestyle changes. Pdf oral n acetyl cysteine for meconium ileus of preterm. Unlike in the meconium plug syndrome, the meconium is abnormal in consistency. The term meconium disease refers to meconium ileus and meconium plug syndrome. In a barium enema, meconium plug syndrome shows a normal or dilated colon as compared to microcolon in meconium ileus. Cystic fibrosis presenting with the meconium plug syndrome. Symptoms and signs infants present in the first few days of life with failure to pass stools, abdominal distention, and vomiting. Feb 15, 2017 meconium plug syndrome also termed functional immaturity of the colon, colonic immaturity, small left colon syndrome, and functional colonic obstruction is a transient disorder of the newborn colon characterized by delayed passage 2448 hr of meconium and intestinal dilatation. A plea ismade to restrict the name meconium plug syndrome to cases in which the meconium plug is white and.
During the first day of life abdominal distention was noted and the infant had not passed any meconium. The meconiumplug syndrome and hirschsprungs disease. Jan 12, 2012 meconium aspiration syndrome is a serious condition in which a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time of delivery. Meconium ileus has a significant risk of intestinal perforation. Meconium plug syndrome, cystic fibrosis, and exocrine. It also is caused by amniotic fluid the fluid that surrounds the baby while in his or her mothers uterus. Meconium can be tested for various drugs, to check for in utero exposure. Request pdf meconium plug syndrome meconium plug syndrome was first reported by clatworthy in 1956, describing a syndrome of colonic obstruction. Meconium plug syndrome free download as powerpoint presentation. It appears that the incidence of hirschsprungs disease remains around % as initially reported when the syndrome was defined. Go to previous content download this content share this content add this content to favorites go to next content. Meconium forms a cast of the colon, and the colon remains normal in caliber. Meconium ileus in cystic fibrosis journal of cystic fibrosis.
The incidence is one in 1,000 births, and it is associated. In the other report, meconium plug syndrome is in fact defined as meconium located in the colon but does not speak of whether the population is meconium exclusively in the colon. Meconium plug syndrome refers to a functional colonic obstruction in a newborn due to an obstructing meconium plug. The meconium plug syndrome mps is a common cause of low intestinal obstruction in newborn infants.
Meconium plug syndrome merck manuals professional edition. Full text get a printable copy pdf file of the complete article 1. Pdf primary segmental volvulus of the ileum mimicking. Pdf we report a case of meconium plug syndrome that presented with classical clinical and radiological features of acute intestinal. Its dangerous when the baby inhales either of these substances into his or her lungs before, during, or after birth. Generally, infants with meconium plug syndrome have normal bowel function after passing the meconium plug. The clinical picture is that of a low small bowel obstruction in the neonatal period.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Sep 25, 2014 meconium plug syndrome was first reported by clatworthy in 1956, describing a syndrome of colonic obstruction because of inspissated meconium. Symptoms include failure to pass meconium within the first 24 to 48 hours after birth, abdominal distension, and vomiting if complete intestinal blockage occurs. Meconium plug syndrome associated with cystic fibrosis and. Hop 2 1 department of pediatric radiology, sophia childrens hospital, erasmus university, rotterdam, the netherlands. Meconium aspiration syndrome is a serious condition in which a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time of delivery. Meconium, a dark green material, is a newborns first stool. A barium enema examination should be performed as soon as the obstruction is suspected, as it will usually lead to the correct diagnosis.
1130 1235 786 1538 869 528 749 1328 87 850 1562 602 1104 888 1001 1134 531 652 30 308 160 733 13 74 787 743 824 1106 978 1227 1492 658 556 2 1474 1440 1254 1198 501 1013 754 647