Contrast Enema for neonatal distal bowel obstruction: The diagnostic and pathological yield

Abstract

Abstract Purpose: Neonatal distal bowel obstruction (DBO) can present a diagnostic challenge [1, 2] As different aetiologies have similar clinical manifestations with not all surgical intervention [2, 3]. Contrast enemas (CE) can help differentiate the aetiology avoiding the need for surgery [2–4]. We reviewed 20years of CE to evaluate their diagnostic and pathological yield in neonatal DBO. Method: CE for DBO undertaken in neonate between 2001 and 2021 were reviewed with studies. Medical records for 98 patients (109 CE) were accessed to review the results, the definitive diagnosis, birth weight, gestation and age at time of CE. Results: Meconium plug syndrome (MPS) (n = 32) was the commonest radiological diagnosis followed by bowel atresia (n = 20), Hirschsprung’s disease (HD) (11) and meconium ileus (10). Of the CE 16% were normal, 14% were non diagnostic. One third of patients with a radiological diagnosis of MPS had a eventual definitive diagnosis that required surgical intervention, either HD, meconium ileus or SBO. The definitive diagnosis was most commonly MPS (n = 29), followed by HD (21) and bowel atresia (16). There were no statistically significant differences in demographics among the definitive diagnoses. Conclusion: CE in neonatal DBO has a high diagnostic and pathological yield aiding in determining which patients require surgery. Level of Evidence: Level IV