RESUMO
Many infants with congenital hypothyroidism have few or no clinical manifestations at birth. In preterm infants, discovering related signs and symptoms of congenital hypothyroidism is even more difficult, despite the higher incidence of transient thyroid function abnormalities. Therefore, these patients need to be closely monitored during the early neonatal period. We report a case of a very low birth weight infant presenting with meconium obstruction concurrent with congenital hypothyroidism in the early neonatal period. Unless diagnosed and treated appropriately, meconium obstruction of prematurity may lead to feeding intolerance, intestinal perforation, necrotizing enterocolitis, and sepsis. It is important for medical caregivers to understand that meconium obstruction can be an early sign of congenital hypothyroidism in preterm infants with abdominal distension.