Neonatal megacolon is complicated by life-threatening small bowel colitis, intestinal perforation, and questionable pathology that requires fistula. 1. Complicated with life-threatening small bowel colitis: when conservative treatment is ineffective, it is necessary to carry out emergency caesarean section, intraoperative frozen pathology examination, and fistula. 2. Complicated intestinal perforation: the condition of these children is often more serious, and the dilatation of the colon is often not obvious, intraoperative biopsy of the colon or rectum should be carried out in order to clarify the diagnosis. 3. Dilated section of intestinal tube is long: some scholars suggest that this part of the children should be fistula, waiting for 3-6 months before radical surgery. 4. Pathological examination is in doubt: for neonatal intestinal obstruction, intestinal perforation, clinical suspicion of megacolon, emergency surgical exploration of the hospital if the lack of experienced pathologists, intraoperative operation is appropriate to carry out the terminal ileostomy or perforation repair, perforation proximal mesenterostomy. 5. Long-segmented, total colonic megacolon: such patients are recommended to first fistula, and then radical surgery. 6. Down syndrome or developmental delay: for these patients with small bowel colitis in the neonatal period, colostomy is appropriate. In addition, other causes of developmental delay in children with megacolon, the postoperative cause of perianal erosion, incontinence and intestinal obstruction is also more difficult to deal with than the average child, so it is advisable to choose the first colostomy. Newborns with megacolon should seek prompt medical attention, complete the relevant examinations, and listen to the guidance of specialized physicians.