Background: If a newborn does not pass the first bowel movement within 48 hours, there may be an underlying cause. We describe a rare cause of delayed meconium passage.
Case description: The neonate was born after a gestational age of 40 weeks and 2 days. The home birth was followed by a good start. Radiological imaging was performed due to the absence of the first stool and an increase in abdominal distention. The imaging showed an abnormal course of the colon with an sudden stop. Subsequently, surgery was conducted and an intestinal malrotation with a colonic atresia was found. During the surgery, a colonic anastomosis with a deviating loop ileostomy were constructed. The postoperative course was uneventful.
Conclusion: Delayed meconium passage has a very extensive differential diagnosis, in which an atresia of the intestine is one of the possibilities. A quick and structured approach is essential to prevent a possible blow-out of the intestine.