Neonatal meconium blockage in the ileum and proximal colon

Three cases of premature infants with obstruction of the ileum and proximal colon in the absence of cystic fibrosis are presented. Meconium inspissation complicated low-grade bowel obstruction in 2 infants. In the third, the bowel was anatomically normal, with the tenacious meconium the apparent primary cause of obstruction. Distinguishing features of this unusual type of blockage and other meconium syndromes are also discussed. This condition may simulate necrotizing enterocolitis, requiring surgery for differentiation. It should be considered in the differential diagnosis of low small bowel or colonic obstruction in the premature infant who is several days of age.