Neonatal small left colon syndrome (NSLCS): Rare but important complication in an infant of diabetic mother

Description

A female infant born at 35+6 weeks by caesarean section to a mother with poorly controlled type 1 diabetes was admitted to the neonatal unit due to hypoglycaemia. Birth weight was 3.2 kg (91–98th centile). On day 1, the baby required a glucose load of 10 mg/kg/min to maintain normoglycaemia. By day 2, her blood sugar levels stabilised, feeds were started and intravenous fluids were weaned. With the introduction of feeds, she had milky vomits and abdominal distension. Feeds were stopped and an abdominal X-ray showed a dilated transverse colon with an abrupt transition zone at splenic flexure (figure 1, arrow indicates transition zone). Symptoms resolved after passage of a large, thick plug of mucus and meconium that resembled an intestinal cast (figure 2). 

Figure 1

Patient's plain abdominal X-ray. There is a dilated transverse colon and calibre change at the splenic flexure indicates...

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