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Korean J Radiol 2022 01;23(1):124-138

Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Gastrointestinal (GI) emergencies in neonates and infants encompass from the beginning to the end of the GI tract. Both congenital and acquired conditions can cause various GI emergencies in neonates and infants. Given the overlapping or nonspecific clinical findings of many different neonatal and infantile GI emergencies and the unique characteristics of this age group, appropriate imaging is key to accurate and timely diagnosis while avoiding unnecessary radiation hazard and medical costs. Read More

BMC Pediatr 2021 02 19;21(1):91. Epub 2021 Feb 19.

Department of Radiology and Research Institute of Radiological Science, Severance Children's Hospital, Yonsei University College of Medicine, 50-1Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.

Background: In neonatal intensive care unit (NICU) patients with intubation status, fluoroscopic evaluation for the bowel is limited. This study was to evaluate the utility of bedside upper gastrointestinal (UGI) series with delayed radiographs (DR) for assessing duodenojejunal junction (DJJ) and small bowel passage in NICU patients with nonspecific bowel ultrasonography and contrast enema findings.

Methods: We reviewed clinical and imaging data for bedside UGI with DR of NICU patients from 2014 to 2019. Read More

J Clin Ultrasound 2021 May 11;49(4):405-407. Epub 2020 Sep 11.

Division of Paediatrics and Neonatal Critical Care, Medical Center "A. Béclère", Paris Saclay University Hospitals, APHP, Paris, France.

We present a case of life-threatening airway obstruction caused by meconium aspiration, a condition with significant neonatal mortality and morbidity. Lung ultrasound detected the obstruction and helped in the clinical management allowing to perform a quick and selective bronchoalveolar lavage with diluted surfactant. Read More

Acad Radiol 2016 May 5;23(5):559-68. Epub 2016 Feb 5.

Department of Radiology, St. Vincent's University Hospital, Elm Park, Merrion Rd, Dublin 4, Ireland.

Rationale And Objectives: The purpose of this study was to critically appraise and compare the diagnostic performance of imaging modalities that are used for the diagnosis of upper and lower gastrointestinal (GI) tract obstruction in neonates and infants.

Methods: A focused clinical question was constructed and the literature was searched using the patient, intervention, comparison, outcome method comparing radiography, upper GI contrast study, and ultrasound in the detection of upper GI tract obstruction such as duodenal atresia and stenosis, jejunal and ileal atresia, and malrotation and volvulus. The same methods were used to compare radiography and contrast enema in the detection of lower GI tract obstruction such as meconium plug syndrome, meconium ileus, Hirschsprung disease, and imperforate anus. Read More

J Pediatr Surg 2020 Sep 30;55(9):e1-e3. Epub 2014 Dec 30.

Department of Pediatric Surgery, University of Poitiers, Poitiers, France.

Neonatal small left colon syndrome is a rare cause of bowel obstruction. Its etiology remains unknown, but a significant association has been noted between maternal diabetes and small left colon. No reported cases within the same family could be found in the literature, excepting 2 sets of twins. Read More

Pediatr Neonatol 2014 Aug 2;55(4):256-61. Epub 2013 Dec 2.

Department of Radiology, Korea University Hospital, Ansan, Gyeonggido, Republic of Korea.

Background: When abdominal distention occurs or bowel obstruction is suspected in the neonatal period, a water-soluble contrast enema is helpful for diagnostic and therapeutic purposes. The water-soluble contrast medium is evacuated through the anus as well as excreted via the kidneys in some babies. This study was designed to evaluate the incidence of renal excretion after enemas using water-soluble contrast media and presume the causes. Read More

J Pediatr Surg 2004 May;39(5):731-7

Division of Pediatric Surgery, University of California, Irvine Medical Center, Orange 92868, USA.

Background: Guidelines for diagnosis and therapy of meconium obstruction in extremely low birth weight neonates are still not well established.

Methods: All low-birth-weight infants presenting with meconium obstruction over a 5-year period were reviewed retrospectively. Patients with meconium plug syndrome or cystic fibrosis were excluded. Read More

Ann Acad Med Singap 2003 Sep;32(5):649-52

Department of Maternal Fetal Medicine, KK Women's & Children's Hospital, 100 Bukit Timah Road, Singapore 229899.

Objective: The objective was to evaluate the incidence of gastrointestinal abnormalities amongst those fetuses with antenatally diagnosed echogenic bowel (EB).

Materials And Methods: A retrospective review of all cases delivered from April 2002 to March 2003 with antenatally diagnosed EB was conducted. This was defined as bowel that appeared as echogenic as (if not greater than) the iliac bone on a real-time image. Read More

Am Fam Physician 1999 Nov;60(7):2043-50

University of Iowa School of Medicine, Iowa City, USA.

Timely passage of the first stool is a hallmark of the well-being of the newborn infant. Failure of a full-term newborn to pass meconium in the first 24 hours may signal intestinal obstruction. Lower intestinal obstruction may be associated with disorders such as Hirschsprung's disease, anorectal malformations, meconium plug syndrome, small left colon syndrome, hypoganglionosis, neuronal intestinal dysplasia and megacystis-microcolon-intestinal hypoperistalsis syndrome. Read More

JBR-BTR 1999 Aug;82(4):159-66

Department of Radiology, University of Antwerp, Universitair Ziekenhuis Antwerpen, Edegem, Belgium.

Intestinal obstruction in the newborn infant may be due to a variety of conditions, including atresia and stenosis, annular pancreas, malrotation, duplication cyst, meconium ileus, meconium plug syndrome and neonatal small left colon syndrome, and Hirschsprung's disease. Neonates with unrecognised intestinal obstruction deteriorate rapidly, show an increase of associated morbidity and appropriate surgical treatment becomes more hazardous. Early diagnosis depends largely on the prompt detection of obstructive manifestations by the clinician and the subsequent accurate interpretation of radiographic findings by the radiologist. Read More

Radiologe 1997 Jun;37(6):432-8

Röntgen- und Schallabteilung, Universitäts-Kinderklinik, Mainz.

Imaging plays a major role in most neonatal gastrointestinal emergencies. The role may vary from helping to establish a diagnosis, to the evaluation of associated abnormalities, to surgical planning, or to therapy for some conditions like meconium ileus or meconium plug syndrome. Plain radiographs and ultrasound serve a primary imaging modalities with bowel contrast examinations, CT scan, and MR imaging playing roles in more complex cases. Read More

Radiographics 1996 Jul;16(4):871-93

Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.

Cystic fibrosis (CF), the most common lethal autosomal recessive disease in white populations, is characterized by dysfunctional chloride ion transport across epithelial surfaces. Although recurrent pulmonary infections and pulmonary insufficiency are the principal causes of morbidity and death, gastrointestinal symptoms commonly precede the pulmonary findings and may suggest the diagnosis in infants and young children. The protean gastrointestinal manifestations of CF result primarily from abnormally viscous luminal secretions within hollow viscera and the ducts of solid organs. Read More

Radiol Clin North Am 1996 Jul;34(4):819-44

Section of Pediatric Radiology, Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis Children's Hospital, Missouri 63110, USA.

Imaging plays a major role in most neonatal gastrointestinal emergencies. The role may vary from helping to establish a diagnosis, to the evaluation of associated abnormalities, to surgical planning, or to therapy for some conditions like meconium ileus or meconium plug syndrome. Plain radiographs and bowel contrast examinations serve as primary imaging modalities with ultrasound, CT scan, and MR imaging playing roles in more complex cases. Read More

Pediatr Radiol 1991 ;21(8):556-9

Department of Pediatric Radiology, Sophia Children's Hospital, Erasmus University, Rotterdam, The Netherlands.

Abdominal plain films of 133 neonates, with 82 cases of meconium plug syndrome (MPS), 27 cases of meconium ileus (MI) and 24 cases of neonatal Hirschsprung's disease (HD), were reviewed to assess the value of such radiographs for diagnosis. The radiographs were examined according to a list of 11 parameters. By using multivariate discriminant analysis, it appeared that 4 parameters i. Read More

J Ultrasound Med 1986 Aug;5(8):425-8

Two cases are reported of patients in the third trimester of pregnancy in whom routine ultrasound examination revealed progressive dilatation of the fetal intestines. Intestinal obstruction was suspected and amniocentesis as well as amniography with Urografin were done. In both cases a regression in dilatation of bowel was noted on ultrasonography. Read More

Pediatr Radiol 1986 ;16(2):162-3

A small left colon has been observed in neonates due to several causes: aganglionosis, meconium plug, and neonatal small left colon syndrome. We report a case of small left colon in an infant with cystic fibrosis, underscoring the need to consider this disease in the diagnostic work up. Read More

Radiology 1984 Feb;150(2):393-400

To determine the relative accuracy of the various radiologic signs of Hirschsprung disease (HD), we retrospectively reviewed both radiographs obtained after a barium enema and the medical records of 62 children who had surgery to prove or exclude the diagnosis of HD. The visualization of a rectosigmoid transition zone was highly predictive of HD, but nonvisualization did not rule out HD. A false positive transition zone at the splenic flexure was seen in four neonates who had small left colon syndrome rather than HD. Read More

Gastrointest Radiol 1981 Jan;6(1):75-8

Two neonates with clinical features of meconium plug syndrome (MPS) were found to have ileocolic intussusception associated with meconium plugs inspissated in the distal ileum. Hydrostatic reduction of the intussusception relieved the intestinal obstruction. Cystic fibrosis was excluded by sweat test and follow-up. Read More

Am J Dis Child 1978 Feb;132(2):167-9

The meconium plug syndrome (MPS) is a common cause of low intestinal obstruction in newborn infants. Usually, it is benign and not associated with other intestinal dysfunction. We describe the cases of three infants in whom there was intestinal obstruction consistent with the MPS and in which cystic fibrosis (CF) was later documented. Read More

Radiology 1977 Nov;125(2):457-62

Neonatal small left colon syndrome is a cause of functional colon obstruction in newborn infants, with a high association of maternal diabetes. There has been much confusion regarding its relationship to meconium plug syndrome and aganglionosis. Six cases of aganglionosis (2 in infants of diabetic mothers) were encountered in which the radiographic findings were identical to small left colon syndrome, indicating the need for caution in dismissing aganglionosis solely on the basis of a small left colon seen radiographically in a newborn infant with colon obstruction. Read More

J Singapore Paediatr Soc 1977 Jun;19(2):121-5

Am J Roentgenol Radium Ther Nucl Med 1974 Feb;120(2):342-52

Radiology 1972 Jul;104(1):113-4

Am J Roentgenol Radium Ther Nucl Med 1968 Jun;103(2):339-46