*2.5.2 Nonoperative treatment*

Nonoperative management can be achieved by diatrizoate meglumine enemas as first described by Noblett in 1969 [30]. Variations on his approach have been established as effective first-line treatment for uncomplicated meconium ileus.

Uncomplicated meconium ileus obstruction can be relieved by giving one or more dilute diatrizoate sodium or diatrizoate (gastrografin) enema (with N-acetylcysteine added) under fluoroscopic guidance. The hyperosmolar nature of this compound increases the influx of fluid into the bowel lumen to liquefy the viscid meconium and thus facilitate its expulsion with consequent large gastrointestinal water losses. While carrying out this procedure, therefore, adequate intravenous fluid administration must be ensured to prevent hypovolemia.
