Practical Imaging Approach to Bowel Obstruction in Neonates: A Review and Update

Abstract

The newborn with intestinal obstruction can elicit unease in many radiologists and neonatologists. The clinical presentation may be nonspecific, with bilious or nonbilious vomiting, abdominal distension, and often failure to pass meconium evident. The etiology of neonatal intestinal obstruction could lie anywhere from esophagus to anus. Some disorders, such as malrotation with midgut volvulus, are lifethreatening and require prompt decision-making, whereas others, such as duodenal atresia, which often have a similar clinical presentation, may be managed semielectively. This is one scenario in which the application of a logical approach, radiology, provides the most definitive information. The overarching goal of this article is to provide a helpful and practical imaging strategy for evaluating newborn intestinal obstruction and to review the myriad causes as well as their characteristic imaging features.