Paediatric surgery: meconium plug syndrome: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Paediatric surgery: meconium plug syndrome

Sample item

A term infant of a diabetic mother has delayed passage of meconium and abdominal distension. A water-soluble contrast enema shows a narrow descending colon with a dilated transverse colon, and a plug of meconium is then passed with relief. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Small left colon syndrome

In small left colon syndrome (meconium plug syndrome), immaturity of the left colon in infants of diabetic mothers gives a narrow descending colon on contrast enema. The enema is both diagnostic and therapeutic as the plug is passed. Biopsy is still considered if symptoms persist to exclude Hirschsprung disease.

Option by option

  • A. Anorectal atresia

    Anorectal atresia is evident on inspection by the lack of an anal opening.

  • B. Small left colon syndrome (correct)

    Correct. A narrow left colon with a plug cleared by the contrast enema in an infant of a diabetic mother is typical.

  • C. Meconium ileus

    Meconium ileus is distal ileal obstruction, usually from cystic fibrosis, with a microcolon.

  • D. Hirschsprung disease

    Hirschsprung disease shows a transition zone and persistent obstruction, and a single plug does not cure it.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Small left colon syndrome. In small left colon syndrome (meconium plug syndrome), immaturity of the left colon in infants of diabetic mothers gives a narrow descending colon on contrast enema.

Why is "Anorectal atresia" not the answer?

Anorectal atresia is evident on inspection by the lack of an anal opening.

Why is "Meconium ileus" not the answer?

Meconium ileus is distal ileal obstruction, usually from cystic fibrosis, with a microcolon.

Why is "Hirschsprung disease" not the answer?

Hirschsprung disease shows a transition zone and persistent obstruction, and a single plug does not cure it.

What concept does this question test?

It tests Paediatric surgery: meconium plug syndrome in General Surgery. The enema is both diagnostic and therapeutic as the plug is passed. Biopsy is still considered if symptoms persist to exclude Hirschsprung disease.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric surgery: meconium plug syndrome?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.