Neonatal Intestinal Obstruction

Neonatal intestinal obstruction is due to a variety of acquired or congenital causes, the most common of which is septic ileus. Mechanical causes include small and large intestinal atresias, anorectal malformations, intestinal malrotation/volvulus, incarcerated inguinal hernia, congenital bands, and intra-abdominal cysts. Functional causes include Hirschsprung's disease, meconium ileus, maternal substance abuse, metabolic conditions, and prematurity. The obstruction classically presents with bilious vomiting, abdominal distension, and failure to pass meconium. The mainstay of treatment is fluid resuscitation and gastric decompression, followed by surgical management in most cases, as bilious vomiting is to be considered as a surgical emergency until proven otherwise.