Meconium Plug Syndrome

  • Etiology: immature enteric plexus causing functional immaturity of colon
  • Enema: narrow caliber left colon with a long meconium filling defect / cast
  • Clinical: seen in infant of diabetic mother, infant of mother who has had MgSO4, usually spontaneous resolution but 25% have underlying Hirschsprung disease so if obstructive symptoms persist after enema perform rectal biopsy

Cases of Meconium Plug Syndrome

Enema of meconium plug syndrome
Enema shows the left colon to be smaller in caliber than the rest of the colon. There is a long meconium filling defect throughout the colon.
Clinical image of meconium plug
Clinical image shows a contiguous plug of meconium that was expelled by the patient after a water-soluble contrast enema.
Barium enema of meconium plug syndrome
AXR shows a distal bowel obstruction. Water-soluble contrast enema shows normal caliber of the ascending and transverse colon and rectum, but decreased caliber of the descending (left) colon.