Contrast enema : Gastrografin is a hypertonic solution containing both wetting and detergent agents. However, it is associated with complications secondary to hyperosmolarity which can lead to dehydration (Fig. 28.1b).

When meconium plug syndrome is suspected, water-soluble contrast is used not only as a diagnostic tool but also to provide therapeutic benefits in helping to expel the meconium plugs from the colon and relieve the obstruction.

Contrast enema usually shows a moderately dilated colon filled with radiolucent material (the meconium plug that produces a double-contrast effect).

Contrast enema usually eliminates congenital small bowel obstruction and rare colon abnormalities.