The differential for low obstruction is ileal atresia, meconium ileus, meconium plug syndrome and Hirschsprung disease.
2.
In barium enema, meconium plug syndrome rather shows normal or dilated colon as compared to micro-colon in meconium ileus.
3.
Meconium ileus should be distinguished from meconium plug syndrome, in which a tenacious mass of mucus prevents the meconium from passing and there is no risk of intestinal perforation.