Small Left Colon Syndrome (Differential Diagnosis)

In this newborn no meconium has been evacuated by the anus in the first 24 to 36 hours. Therefore, a contrast enema is performed which shows the whole colon and terminal ileum filled with contrast. Starting from the left colon flexure, a narrow colon descendens is recognizable. The relatively large rectum and distal sigmoid, the distinct haustration of the colon descendens, and the sudden change of the diameter beyond the left colonic flexure do not support a long-distance Hirschsprung's disease. Due to the clinical follow-up with spontaneous evacuations of stools within 10 to 14 days after birth and the reversibility of the earlier described pathological x-ray findings, the diagnosis is a small left colon syndrome (transient functional disturbance of stool evacuation). The passage of air and stools has been promoted in the first 2 weeks after birth by daily retrograde rectal irrigations.