Newborn with failure to pass meconium and bilious vomiting

Enema of meconium plug syndrome
AP image from a contrast enema exam (left) shows a long filling defect in the colon within a normal caliber colon. The cecum was noted to be in the left mid abdomen. The terminal ileum was not refluxed. AP image from an upper GI exam (right) shows that while the duodenal jejunal junction projects over the left pedicle of the spine it is much lower in position than the duodenal bulb.

The diagnosis was malrotation without midgut volvulus in a patient with meconium plug syndrome.