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[Microcolon in newborns: clinical significance and differential diagnosis]
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Abstract:
Microcolon is a radiological finding of a colon of tiny caliber on barium enema examination. There are no absolute standards for measurement of this condition which is probably caused in utero by lack of appropriate distention of the colon with intramural content. A review was undertaken of 228 barium enema examinations of newborns admitted to Mackay Memorial hospital from January 1987 to December 1988. Twenty cases (8.7%) were regarded by the same radiologist as microcolon. Among them, ileal atresia was found in nine cases (45%); colonic atresia in two cases (10%); total colon agangliosis in three cases (15%); prenatal volvulus in two cases (10%); meconium ileus in two cases (10%); duplication of ileum in one case (5%): and megacystis-microcolon-intestinal hypoperistasis (MMIHS) in one case (5%). The characteristic features of plain abdomen and barium enema study were discussed. The finding of a microcolon on contrast enema study in newborn with lower gastrointestinal obstruction signifies that it may rise from lower gastrointestinal obstruction above colon, external compression, or motility disorder of the intestine itself. The outcome of microcolon seems to depend on its underlying causes. In those caused by obstruction, only the caliber may return to normal within days after removal of the obstruction.
Insights
Microcolon, a tiny caliber colon in newborns, is often linked to various gastrointestinal obstructions. Identifying microcolon on barium enema can indicate serious underlying conditions requiring prompt diagnosis and management.
Area of Science:
- Pediatric Radiology
- Neonatal Gastroenterology
- Surgical Neonatology
Background:
- Microcolon is a radiological finding characterized by a colon of tiny caliber on barium enema examination.
- Its etiology is often attributed to intrauterine lack of adequate colon distention due to intramural content.
Purpose of the Study:
- To review cases of microcolon in newborns and analyze the associated gastrointestinal abnormalities.
- To discuss the diagnostic features and implications of microcolon in neonatal lower gastrointestinal obstruction.
Main Methods:
- A retrospective review of 228 barium enema examinations in newborns was conducted.
- Cases identified as microcolon by a single radiologist were analyzed for associated diagnoses.
Main Results:
- Twenty cases (8.7%) of microcolon were identified.
- Associated conditions included ileal atresia (45%), colonic atresia (10%), total colon agangliosis (15%), prenatal volvulus (10%), meconium ileus (10%), ileal duplication (5%), and megacystis-microcolon-intestinal hypoperistasis (MMIHS) (5%).
Conclusions:
- Microcolon in newborns signifies lower gastrointestinal obstruction, external compression, or intestinal motility disorders.
- The prognosis of microcolon is dependent on the underlying cause; caliber may normalize post-obstruction relief.