Radiographic manifestations of intestinal obstruction in the newborn

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. Plain film of the abdomen is often helpful in determining the level of obstruction and usually dictates, together with clinical symptoms, the choice of the contrast study firstly to perform. In this article we will review the clinical and radiological signs of different pathological conditions causing intestinal obstruction in the newborn.