Meconium ileus and meconium plug syndrome

Abstract Meconium abnormalities, characterized by the clinical spectrum of distal bowel obstruction in the newborn, can be either functional or mechanical and range from the more benign meconium plug syndrome (MPS) to complex meconium ileus (MI). Functional distal bowel obstructions in the newborn include MPS, Hirschsprung disease, and small left colon syndrome. Mechanical obstruction can be due to distal bowel atresia or MI, which is often the first clinical manifestation of cystic fibrosis (CF). Distal intestinal obstruction syndrome occurring in the older child or adult with CF is partial or complete bowel obstruction due to inspissated faeces in the terminal ileum. This chapter explores the pathophysiology, pathology, investigations, non-operative and operative treatment strategies, and outcomes of these conditions.