Functional intestinal obstruction in the neonate.

The number of neonates with functional intestinal obstruction being admitted to this surgical unit is increasing. The obstruction may be transient and curable within a few days, or weeks or, more rarely, may be prolonged and intransigent, usually resulting in death despite parenteral nutrition. In the former group, the infants are often the result of an abnormal pregnancy or delivery. Recently, a small number of infants has been identified in whom prolonged jaundice is a notable feature, but the aetiology of this syndrome is not apparent. All of these infants must be screened to exclude mucoviscidosis, septicaemia, meningitis, and Hirschsprung's disease. Ideally, neonates suspected of having Hirschsprung's disease should not be submitted to surgery until after histological proof of the diagnosis. Infants with the rarer forms of intransigent ileus should be referred to special centres for intensive investigations, much of which would be somewhat experimental, in order to discover more about the aetiology of the various syndromes. For the adequate investigation and treatment of any these infants, an experienced team of clinicians, radiologists and pathologists is essential, and these infants should not be treated where the necessary facilities are unavailable.