Case#1 was the 874-g（－2.76 SD）girl born at 30 weeks and 4 days. She did not excrete any feces by herself and glycerin enema was performed at 3 days of age. Lower GI series was performed with Gastrografin（G）at 4 days of age. After that, abdominal distention was attenuated.
Case#2 was the 927-g（－2.94 SD）boy born at 31 weeks and 2 days. G enema was performed at 3 days of age. After lower GI series at 4 days of age, a large amount of meconium was excreted. However, abdominal distention and intestinal tract extension continued, so that G was infused by a gastric tube at 5 days of age. Excretion of G and meconium was then checked. After abdominal distention attenuated, enteral feeding was resumed.
Case#3 was 862-g（＋0.59 SD）girl born at 25 weeks and 1 day. Urgent laparotomy was performed due to gastrointestinal perforation at 7 days of age. Operative diagnosis was meconium-related disease.
Case#4 was 675-g（－1.57 SD）boy born at 26 weeks and 4 days. G enema was performed at 1 days of age, and G was infused from the gastric tube at 2 days of age. Lower GI series was performed at 3 days of age, and G was infused to the ileocecal region. However, abdominal distention was not attenuated, so that ileostomy was performed at 8 days of age.
G infusion to lower GI tract was effective for diagnosis and treatment of meconium-related ileus. If lower GI infusion is not effective, G infusion to both upper and lower GI tracts could be the next intervention. However, in infants who do not respond to these treatments, laparotomy may be required at one week of age to exclude ileal atresia.
