INTRODUCTION Meconium ileus refers to intestinal obstruction in the newborn infant by abnormal, thick, tenacious meconium. This type of obstruction accounts for approximately 15% of all types encountered in the neonatal period. The usual site of the obstruction is the terminal ileum. which may be greatly distended and hypertrophied. The length of ileum plugged with meconium may vary from a few centimeters to over 3 ft. Late recognition of this condition, with the development of serious complications, such as intestinal perforation with meconium peritonitis, gangrene of the intestine, and aspiration pneumonia, explains the high mortality rate in the past. Prior to 1945, almost all infants with meconium ileus died, although rare instances of recovery have been reported.1The few infants who survived surgery in the neonatal period died later in infancy with an obstructive and suppurative pulmonary process; this latter represents another serious manifestation of the generalized disease of