Journal List > Korean J Pediatr Gastroenterol Nutr > v.14(1) > 1043529

Korean J Pediatr Gastroenterol Nutr. 2011 Mar;14(1):52-58. Korean.
Published online March 31, 2011.
Copyright © 2011 The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition
Meconium Obstruction in Very Low Birth Weight Infants
Ki Bae Hong, M.D., In Chang Seong, M.D., Kun Song Lee, M.D., Young Pyo Chang, M.D., and Hee Seung Song, R.N.
Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korean.

Corresponding author (Email: )
Received August 07, 2010; Revised September 10, 2010; Accepted September 10, 2010.



Mecnoium obstruction in very low birth weight infants (VLBWI), which delays enteral feeding and is one of the major causes of bowel obstruction, can be diagnosed and treated with hyperosmolar water-soluble contrast enema. The purpose of this study was to observe the clinical findings of meconium obstruction, the improvement of small bowel obstruction after contrast enema, and the complications related to the enema.


Hypersolmolar water-soluble contrast enemas were performed in 14 VLBWIs with meconium obstruction. Clinical findings, radiologic findings, feeding intolerance, effectiveness, and complications of enemas were observed. Also, clinical findings related to meconium obstruction were compared with 18 VLBWIs without meconium obstruction.


1) Fourteen VLBWIs with meconium obstruction had significantly lower 5 minutes Apgar scores than 18 VLBWIs without meconium obstruction (p<0.05). Moreover, the day of last meconium passing, and the day of the first trial and full enteral feeding were delayed significantly. 2) A total of 18 enemas were performed in the 14 infants. The contrast medium passed the ileocecal valve and reached the terminal ileus in 12 enemas. Of the 12 enemas, 11 were successful, but 1 infant underwent an ileotomy, even though the contrast medium reached the terminal ileum. 3) Intestinal obstruction was not relieved in three of five infants, in whom the contrast medium failed to pass the ileocecal valve. Obstruction was relieved after repeated enemas in which the contrast medium reached the terminal ileum. 4) No complications associated with water-soluble contrast enemas were observed.


Hyperosmolar water-soluble contrast enema is considered to be safe and therapeutic for meconium obstruction in VLBWIs.

Keywords: Infant; Low birth weight; Contrast media; Enema; Meconium; Ileus


Table 1
Comparison of Perinatal and Neonatal Characteristics between Infants with and without Meconium Obstruction
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Table 2
Comparison of Meconium Passage and Feeding between Infants with and without Meconium Obstruction
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Table 3
Radiologic Findings on a Contrast Study of Meconium Obstruction in Very Low Birth Weight Infants
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Table 4
Findings Related to Hyperosmolar Water-soluble Contrast Enema
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