Clinical Presentation

A neonate with vomiting and abdominal distension.

Further Work-up

(A,B) Abdominal plain films show multiple loops of dilated small bowel with air-fluid levels. There is no air distally (arrow). (C,D) Contrast enema: The entire colon is small and unused. Contrast does not reflux into the terminal ileum (arrow).

Differential Diagnosis

• Ileal atresia: Findings of microcolon and the inability to reflux contrast into the terminal ileum suggest ileal atresia.

• Meconium ileus: