What is the differential diagnosis for a newborn not passing meconium (fecal matter)?

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Differential Diagnosis for Not Passing Meconium

  • Single Most Likely Diagnosis
    • Cystic Fibrosis: This is a common cause of intestinal obstruction in newborns due to the thick, sticky meconium that can block the intestines. It's an important diagnosis to consider because early intervention can improve outcomes.
  • Other Likely Diagnoses
    • Hirschsprung's Disease: A congenital condition characterized by the absence of ganglion cells in the distal bowel, leading to a functional obstruction. It's a common cause of failure to pass meconium within the first 48 hours of life.
    • Intestinal Atresia: A congenital anomaly where there's a complete or partial obstruction of the intestine, which can prevent the passage of meconium.
    • Meconium Ileus: A condition where the meconium in the intestine is thicker and stickier than normal, causing a blockage. It's often associated with cystic fibrosis.
  • Do Not Miss Diagnoses
    • Intestinal Volvulus: A condition where the intestine twists around itself, cutting off blood supply. It's a surgical emergency that requires prompt intervention to prevent tissue death.
    • Necrotizing Enterocolitis: A serious condition where a portion of the bowel tissue dies due to lack of blood supply. It's more common in premature infants but can occur in term babies as well.
  • Rare Diagnoses
    • Congenital Aganglionic Megacolon (Total Intestinal Aganglionosis): A rare form of Hirschsprung's disease where the entire intestine lacks ganglion cells.
    • Chronic Intestinal Pseudo-Obstruction: A rare condition characterized by recurrent episodes of intestinal obstruction without any mechanical cause.
    • Meconium Plug Syndrome: A rare condition where a plug of meconium blocks the intestine, often associated with maternal diabetes or other maternal medical conditions.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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