The differential diagnosis is small left colon syndrome, meconium plug or Hirschsprung's disease. I colonic atresia where the diaphragm bulges back into the lumen of the more proximal portion of the colon. Water-soluble contrast is utilized since the distal end may be open to the peritoneal cavity. Also, if meconium plug is present, water contrast will help to loosen the plug and help it be evacuated. Multiple dilated hyperperistalsing loops of fluid-filled bowel are seen.
Plain radiographs show evidence of low intestinal obstruction.
Speckled meconium may be present in dilated bowel. The prognosis is poor if this procedure is done at an age of greater than 4 days.