Differential diagnosis of complications of meconium

• Meconium aspiration syndrome
• Meconium plug syndrome
• Meconium obstruction of prematurity
• Uncomplicated meconium ileus
• Complicated meconium ileus
• Distal intestinal obstruction syndrome

Approach to the differential diagnosis of complications of meconium:

• Meconium aspiration syndrome should be assumed to be the cause of respiratory distress in the term / post-term infant with coarse interstitial infiltrates and hyperexpansion
• Meconium plug syndrome is associated with a small caliber left colon on enema
• Meconium obstruction of prematurity is only seen in extreme prematurity, does not have a microcolon, multiple plugs of meconium are seen in colon and small bowel
• Complicated meconium ileus is usually associated with extensive fine calcifications on AXR
• Uncomplicated meconium ileus is associated with a microcolon on enema
• Distal intestinal obstruction syndrome can be assumed when a patient with cystic fibrosis presents with abdominal pain and stool in their distal small bowel