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A L Luque Pérez, R Martín-Crespo Izquierdo, H Ramírez Velandia, N Carrera Guermeur, A Escobar Izquierdo, I Pérez Heras, Przemyslaw Maruszewski, J C Moreno De Prado, A Pantoja Bajo, R Luque Mialdea
Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica, Volume 32, pp 158-163

Abstract:
To assess the importance of prenatal ultrasound diagnosis of the fetus carrying meconium periorchitis and its predictive relevance for fetal monitoring and prognosis in the context of acute fetal intestinal disease. Three male fetuses have been diagnosed of meconium periorchitis in our Unit of Fetal Medicine in the last 5 years. Their prenatal ultrasound diagnoses were: testicular tumor (n=1); Meconium periorchitis with acute fetal intestinal perforation (n=2). Gestational age at diagnosis was 33, 34 and 35 weeks. Ultrasound signs at diagnosis were: Increased size of scrotal zone, with hyperechogenic lesions inside and permanence of peritoneum-vaginal canal; at abdominal zone, echographic signs of intestinal disease with or without meconium peritonitis were found (hyperechogenic lesions, edema of intestinal loops and ascites). All three neonates were assessed postnatally by ultrasound and therapeutic indication. Fetal ultrasound findings influenced both evolution and termination of pregnancy. The diagnosis of meconium periorchitis was confirmed postnatally in all cases: in the 1st case, delivered at term, scrotal tumoral pathology was ruled out and did not require abdominal surgery; the other 2 patients were delivered at the same week of prenatal diagnosis and an inguinal-scrotal surgery with intestinal approach because of meconium peritonitis was performed. No patient underwent orchiectomy, maintaining the teste-epididymal binomial intact. Prenatal ultrasound diagnosis of meconium periorchitis requires a strict ultrasound follow-up of the fetus as it is a specific marker of intestinal perforation, which can lead to the termination of pregnancy and avoid appearance of complicated meconium peritonitis.
, Afif N. Kulaylat
Published: 5 February 2019
The publisher has not yet granted permission to display this abstract.
, , , A Liard, G Labadie,
Journal de Gynécologie Obstétrique et Biologie de la Reproduction, Volume 32

Abstract:
Meconium peritonitis is an inflammatory peritonitis induced by meconium extruding into the peritoneal cavity through a perforation of the fetal intestine. Antenatal diagnosis is possible. Prognosis depends on the pathology having caused perforation. This is often unknown. The objectives of this article are to analyze the contribution of antenatal investigations to estimating neonatal prognosis of meconium peritonitis, and to define optimal management. We describe a case of meconium peritonitis diagnosed in utero with particularly severe ultrasound presentation suggesting a potentially lethal course for the neonate. An eutrophic infant was delivered vaginally after preliminary aspiration of the meconium ascites. The neonate presented with a very distended abdomen and responded well to neonatal resuscitation. Laparotomy exploration confirmed the diagnosis of meconium peritonitis. No cause was identified. No obvious perforation was found. The postsurgery period was uneventful. At later follow-up the infant was doing well, free of further problems notably of any digestive disorder. Antenatal ultrasound features suggestive of severe meconium peritonitis are distended fetal bowel loops, huge cystic masses, major meconium ascites, and polyhydramnios. These neonates have a high risk of obstruction and intestinal perforation. Intestinal resection is frequently required. Cardiopulmonary resuscitation is necessary more often in these neonates with a higher risk of fatal outcome due to respiratory distress syndrome or surgery complications. Prognosis remains good after antenatal diagnosis for neonates free of cystic fibrosis, providing delivery takes place in a center with adequate technical facilities.
Published: 16 November 2018
Radiology Case Reports, Volume 14, pp 235-237; https://doi.org/10.1016/j.radcr.2018.10.013

Abstract:
Meconium pseudocyst (MPC) is a rare but well-known surgical condition due to prenatal bowel perforation. A case of MPC secondary to prenatal bowel perforation is presented. Massive ascites requiring peritoneal drainage and disappearance of prenatal intraperitoneal calcifications have not been previously reported in MPC. MPC may present at birth with large ascites requiring peritoneal drainage to establish breathing and ventilation. Absence of prenatal intra-abdominal calcifications does not rule out MPC.
H Bitterlich
Published: 7 February 1970
Zentralblatt fur Gynakologie, Volume 92, pp 189-90

Kevin P Lally, John R Mehall, Hasen Xue, Julie Thompson
Published: 1 January 1999
Journal of pediatric surgery, Volume 34, pp 214-217; https://doi.org/10.1016/s0022-3468(99)90260-9

The publisher has not yet granted permission to display this abstract.
Bhavana Malhotra, Nishant Mittal, Abhishek Jha, N. K. Mittal
International Journal of Contemporary Pediatrics, Volume 6, pp 1753-1756; https://doi.org/10.18203/2349-3291.ijcp20192789

Abstract:
Meconium peritonitis is defined as a sterile chemical or foreign-body peritonitis that is caused by escape of meconium from the intestinal tract into the peritoneal cavity during the fetal or perinatal period. Although meconium peritonitis is indicative of intrauterine perforation of the intestine, it may occur as early as the 4th to 6th month of INTRA NATAL life and as late as several hours after birth. It can be classified into three pathological variations: fibro-adhesive; cystic and generalized. The cystic type has a meconium filled pseudocyst that may rupture in the peritoneal cavity. Intra-abdominal calcification is pathognomonic for the diagnosis. Here, author reported a classical case of meconium peritonitis with pseudocyst formation, which was treated successfully conservatively.
Carman Wing Sze Lai, Noel Wan Man Shek
Obstetrics & Gynecology, Volume 127, pp 740-743; https://doi.org/10.1097/aog.0000000000001337

Abstract:
Fetal meconium peritonitis may develop after severe maternal liver disease. Thus, the latter may warrant heightened fetal surveillance.
M Fujioka, A Bowen
Published: 1 August 1981
Journal: Radiology
Radiology, Volume 140, pp 380-380; https://doi.org/10.1148/radiology.140.2.7255712

Abstract:
Meconium peritonitis occasionally occurs as a localized collection of meconium contained in a cyst made of fibrous granulation tissue. The cyst may contain only meconium or also encase loops of bowel. One such case is reported.
Ankur Rana, Stephen E Dolgin, Chad E Hamner
Published: 4 July 2012
The publisher has not yet granted permission to display this abstract.
MichaelW.L. Gauderer,
Published: 1 January 1992
Pediatric surgery international, Volume 7; https://doi.org/10.1007/bf00181007

The publisher has not yet granted permission to display this abstract.
B A Pletcher, M K Williams, R A Mulivor, D Barth, C Linder, K Rawlinson
Published: 1 November 1991
Obstetrics & Gynecology, Volume 78

Abstract:
Recent reports have suggested that focal hyperechoic abdominal masses detected during the second trimester may represent a normal variation in fetal intestinal development that is transient in nature and not associated with pathologic conditions. The patient described here had second-trimester ultrasonic findings of fetal meconium peritonitis without ascites, polyhydramnios, or other anomalies. Subsequent ultrasound examinations at 22, 30, and 36 weeks demonstrated no change in the abdominal appearance. At birth, this preterm male infant had clinical symptoms of congenital cytomegalovirus infection confirmed by viral culture and serologic studies. Retrospective studies of maternal serum obtained early in the second trimester confirmed a primary cytomegalovirus infection 4 weeks before the initial ultrasound examination. Although fetal hydrops and ascites have occasionally been associated with intrauterine cytomegalovirus infection, fetal meconium peritonitis has not been previously recognized in patients with congenital cytomegalovirus.
K Chalubinski, J Deutinger, G Bernaschek
Published: 1 August 1992
The publisher has not yet granted permission to display this abstract.
, , D.E. El-Metwally
Published: 24 March 2016
Journal of Neonatal-Perinatal Medicine, Volume 9, pp 107-112; https://doi.org/10.3233/npm-16915067

Abstract:
We present the case of an infant born with scrotoschisis and evidence of meconium periorchitis and peritonitis. A scrotal defect was noted with exposure of the left testis and spermatic cord. Meconium peritonitis and periorchitis were confirmed on operative exploration. Given the history, cystic fibrosis was suspected, but initial screening and diagnostic tests were negative.
, Sayu Omori, Toshiyuki Ikeda, Kazumi Yakubo, Tatsuro Fukuiya
Published: 27 September 2015
Case reports in obstetrics and gynecology, Volume 2015, pp 1-2; https://doi.org/10.1155/2015/606134

Abstract:
Meconium periorchitis is a rare disorder caused by fetal meconium peritonitis, with subsequent passage of meconium into the scrotum via a patent processus vaginalis. To date, clinical significance of meconium periorchitis for the prenatal diagnosis of meconium peritonitis and prediction for postnatal surgery remains to be determined. We present a clinical course of a fetus presenting with meconium periorchitis induced by meconium peritonitis. At 28 weeks’ gestation, fetal ultrasonography indicated fetal ascites associated with bilateral hydrocele and peritesticular calcification without other signs of meconium peritonitis. The pregnancy was uneventful until delivery and the infant was delivered at 37 weeks’ gestation. No abdominal distension was observed at birth, and radiography did not reveal any abdominal calcification except for scrotal calcification. Abdominal distension was observed 3 days after birth and laparotomy was performed. The diagnosis of meconium peritonitis was confirmed at surgery. Our case illustrated that careful examination of the scrotum during fetal life was helpful for prenatal diagnosis of meconium peritonitis as well as postnatal management.
Yoshiyuki Nakajima, Naoki Masaoka, Aki Asanuma, Kimie Sone, Masaji Nagaishi, Yasuji Miyakawa, Tatsuo Yamamoto, Mayumi Hoshino,
Published: 29 September 2010
Journal of Medical Ultrasonics, Volume 38, pp 37-40; https://doi.org/10.1007/s10396-010-0281-8

Abstract:
A fetal intraabdominal cystic mass, measuring 6 cm, was detected at 30 weeks of gestation in a 27-year-old gravida 2 para 1 woman. At 33 weeks of gestation, the cyst disappeared. Ultrasonography showed fetal bowel dilatation, polyhydramnios, and intraabdominal calcifications. Fetal meconium peritonitis was diagnosed prenatally. Because the fetal ileus became worse, a cesarean section was performed at 35 weeks of gestation; a female infant weighing 2,131 g with an Apgar score of 8 was delivered. Six hours after birth, the neonate received an ileostomy. The bowel was reanastomosed 42 days after the initial operation. On postoperative pathology, a meconium pseudocyst was diagnosed. To our knowledge, this is the first report of a large fetal meconium pseudocyst that developed into the generalized type in the uterus during the preterm antepartum period.
, Nurettin Karaoǧlanoǧlu, Selami Suma
Published: 30 September 1999
Journal of pediatric surgery, Volume 34, pp 1415-1416; https://doi.org/10.1016/s0022-3468(99)90024-6

Abstract:
Meconium peritonitis is a form of chemical peritonitis resulting from in utero perforation of the gastrointestinal tract, with subsequent leakage of sterile meconium into the peritoneal cavity and the potential spaces connected with it. Involvement of the tunica vaginalis may be the sole presenting clinical manifestation of the gut perforation resolving spontaneously. In such instances, radiologically detectable calcifications in the abdomen, scrotum, and thorax are essential diagnostic points. In this study, a 4-month-old baby with abdominal, scrotal, and thoracic calcifications owing to healed meconium peritonitis is presented.
Margaret M. Olsen, Susan R. Luck, John Lloyd-Still, John G. Raffensperger
Published: 31 October 1982
Journal of pediatric surgery, Volume 17, pp 479-481; https://doi.org/10.1016/s0022-3468(82)80093-6

Abstract:
Meconium diseases in infancy cannot be neatly separated into discrete categories of meconium plug syndrome, meconium ileus, and meconium peritonitis; nor can the therapy of each condition. A patient with any of the three may or may not have cystic fibrosis. All babies with any form of meconium obstruction or atresia must have a sweat chloride test to confirm or rule out this diagnosis. Repeated gastrografin enemas can decrease the need for operative intervention in all babies with meconium plug syndrome and in selected babies with meconium ileus. Babies with meconium diseases can now be managed with a low perinatal mortality.
Pei-Yeh Chang, Fu-Yuan Huang, Ming-Lun Yeh, Jiin-Cherng Sheu, Be-Fung Chen, Chiu-Chiang Chen
Published: 30 September 1992
Journal of pediatric surgery, Volume 27, pp 1217-1219; https://doi.org/10.1016/0022-3468(92)90791-5

Abstract:
Between January 1985 and May 1990, 16 neonates were treated for meconium ileus (MI) at this hospital. All babies were born to Chinese couples. Seven of them were premature, but none of them weighed less than 1,000 g. Eight patients underwent operations either because of mistaken diagnosis, as ileal atresia or long-segment Hirschsprung's disease, or because of complicated MI, including two meconium peritonitis and one associated with ileal atresia. Gastrograffin enema was successful in management of eight uncomplicated MI. The albumin content in the meconium of the last nine cases, including four complicated cases, ranged from 9.2 to 93.3 mg/g dry meconium. Usually, albumin is not present in normal meconium. All cases received sweat test, which were negative. Three patients died in the follow-up period. Sepsis of unknown origin, multiple congenital anomalies, and severe metabolic problems were the causes of death. The other 13 patients are doing well. They have exhibited no pulmonary or digestive problems during their follow-up period, which ranged from 11 months to 5 years. They are healthy and receive regular diets. Growth and development are appropriate for their age groups.
Wendy L. Patton, A. M. Lutz, J. K. Willmann, Peter Callen, A. James Barkovich, C. A. Gooding
Published: 14 September 1998
Pediatric Radiology, Volume 28, pp 714-716; https://doi.org/10.1007/s002470050449

Abstract:
Meconium peritonitis is a chemical peritonitis which occurs following bowel perforation during fetal life. It is generally looked upon as benign, resulting in no long-term sequelae. We present a case of a newborn infant with meconium peritonitis who developed infarcts in several organs. At autopsy the infarcts proved to be caused by emboli as a result of intravascular dissemination of meconium. To our knowledge, this is the first reported case of systemic spread of meconium peritonitis in the literature and suggests that meconium peritonitis may have more serious implications than generally thought.
J R Yankes, J D Bowie, E L Effmann, P B Marshburn, B A Carroll, H C Filston
Published: 1 April 1988
Journal of Ultrasound in Medicine, Volume 7, pp 221-223; https://doi.org/10.7863/jum.1988.7.4.221

, Roderick Houwen
Published: 1 November 2017
Journal of Cystic Fibrosis, Volume 16; https://doi.org/10.1016/j.jcf.2017.06.007

Abstract:
Meconium ileus (MI) is often the first manifestation of cystic fibrosis (CF) and occurs in approximately 20% of patients diagnosed with CF. This article reviews the pathophysiology of MI and its clinical presentation. It focuses on the medical and surgical management emphasizing the importance of nutrition and a multidisciplinary approach to improve both short-term and long-term outcomes for CF patients with MI.
G F Rockwell, M Bean, R Courtney,
Published: 1 February 1984
Clinical Pediatrics, Volume 23

Shinkichi Kamata, Keisuke Nose, Shiroh Ishikawa, Noriaki Usui, Toshio Sawai, Yasuhiro Kitayama, Hirohmi Okuyama, Kenji Imura, Akira Okada
Published: 19 July 2000
Pediatric surgery international, Volume 16, pp 377-379; https://doi.org/10.1007/s003830000354

The publisher has not yet granted permission to display this abstract.
Published: 2 August 2012
Journal of Medical Case Reports, Volume 6, pp 229-229; https://doi.org/10.1186/1752-1947-6-229

Abstract:
Introduction Giant cystic meconium peritonitis is relatively rare. Patients often present with nonspecific physical findings such as distension and emesis. Plain abdominal films remain invaluable for identifying the characteristic calcifications seen with a meconium pseudocyst, and large eggshell calcifications are pathognomonic for the giant cystic subtype. Case presentation We present classic plain X-ray findings and an intraoperative image of a premature low birth weight two-day-old Hispanic male baby treated for giant cystic meconium peritonitis with a staged procedure involving peritoneal drainage, ostomy creation and closure. Conclusion Pediatric surgeons have a range of potential therapeutic approaches for giant cystic meconium peritonitis. A delay of definitive surgical management in the setting of massive abdominal soiling is a safe and acceptable strategy if adequate temporizing drainage is performed in the early perinatal period.
Weng-Hsiang Su, , , Sheng-Ping Chang
Published: 1 November 2002
The Journal of reproductive medicine, Volume 47

Abstract:
Simultaneous fulminant maternal hepatitis B infection and fetal meconium peritonitis has never been reported before in the English-language literature.
D Markov, N Jekova, St Ivanov, V Diavolov, O Brankov
Published: 1 January 2011
Akusherstvo i ginekologiia, Volume 50

Abstract:
Fetal bowel intrauterine perforation causes sterile inflammation of the peritoneum, known as meconium peritonitis. In some cases the perforation closes spontaneously, thus forming a meconium pseudocyst between the intestinal loops and the omentum. Meconium peritonitis, complicated by pseudocyst formation, should always be considered when a fetal abdominal mass with diverse echogenicity and hyperechogenic calcifications is observed on prenatal ultrasound. Usually, this is associated with ascites and/or polyhydramnios. The differential diagnosis necessitates exclusion of all other fetal abdominal tumors. We present a case report of meconium pseudocyst diagnosed prenatally at 32 weeks of gestation which was successfully treated by surgery after birth.
, , , , Kei Takazawa, Kanako C. Kubota,
Published: 1 April 2012
Journal of pediatric surgery, Volume 47; https://doi.org/10.1016/j.jpedsurg.2011.11.050

Abstract:
Meconium peritonitis is a sterile chemical peritonitis caused by bowel perforation with intraperitoneal extravasation of the meconium in utero. When the inflamed intestinal loops become fixed, meconium peritonitis leads to a cystic cavity with a fibrous wall, and the result is termed cystic-type meconium peritonitis. On the contrary, a meconium pseudocyst has a muscle layer continuous with the normal intestine and is distinguished from cystic-type meconium peritonitis based on the histopathologic findings. This report describes the rare case of a neonate complicated by a meconium pseudocyst, which was successfully treated with 1-stage resection and primary anastomosis. There have been few cases of meconium pseudocysts reported in the literature. Meconium peritonitis should be considered in the differential diagnosis in patients who develop large abdominal cysts with air and fluid content. Cystic-type meconium peritonitis is usually treated using drainage with subsequent elective surgery. However, for a meconium pseudocyst, 1-stage intestinal resection with primary anastomosis may be recommended. A meconium pseudocyst may be treatable using 1-stage resection based on histopathologic features.
B. Markowitz, Ralph Loar
American Journal of Obstetrics and Gynecology, Volume 27, pp 733-736; https://doi.org/10.1016/s0002-9378(34)90690-6

The publisher has not yet granted permission to display this abstract.
Faripour Forouhar
Published: 31 May 1984
Medical hypotheses, Volume 14, pp 51-56; https://doi.org/10.1016/0306-9877(84)90062-8

Abstract:
Calcification is the most characteristic pathologic feature of healed meconium peritonitis. Occurrence of calcification in meconium peritonitis has been reported, but its mechanism has not been discussed. According to our studies, the cause of calcification and giant cell reaction is meconium peritonitis is related to several distinct factors leading to three morphologic presentations described under type I, II and III in this paper. These factors can be traced to components of meconium. These morphologic findings are specific and in the proper context diagnostic of meconium peritonitis.
Kathryn Dirkes, Timothy M Crombleholme, Sabrina D Craigo, Laurie A Latchaw, Nabil N Jacir, Burton H Harris, Mary E D'Alton
Published: 31 July 1995
Journal of pediatric surgery, Volume 30, pp 979-982; https://doi.org/10.1016/0022-3468(95)90325-9

Abstract:
The authors reviewed their experience with meconium peritonitis (MP) diagnosed in utero to define criteria for prenatal and postnatal management. Prenatal diagnosis was made by identifying abdominal calcification on serial ultrasound examinations in nine fetuses, between 18 and 37 weeks' gestation. Cases without associated bowel abnormalities were considered "simple MP" and those with bowel abnormalities were considered "complex MP". Five cases of simple MP were identified at 18, 23, 30, 34, and 37 weeks' gestation. These five fetuses were delivered at term and had normal abdominal examinations. Abdominal radiographs were obtained in three showing normal bowel gas patterns, and abdominal calcifications in only two. All five patients were fed uneventfully. Four cases of complex MP were identified at 26, 26, 31, and 31 weeks' gestation. All four fetuses had dilated loops of bowel. Two of the four had meconium cysts, one of which was associated with ascites and the other with polyhydramnios. Shortly after birth both infants with meconium cysts required ileal resection and ileostomy for ileal atresia and ileal perforation, respectively. The remaining two infants had no evidence of dilated bowel, meconium cyst, or ascites on postnatal radiograph and were fed uneventfully. These data suggest that only 22% of fetuses with a prenatal diagnosis of MP develop complications that require postnatal operation. Gestational age at diagnosis does not correlate with postnatal outcome. Fetuses with complex MP are at increased risk for postnatal bowel obstruction and perforation.
, L. Naidu
Published: 1 January 2010
The publisher has not yet granted permission to display this abstract.
G. De Miscault, J. N'senda, M. Schmitt, P. Lascombes, S. Daoud
Published: 1 June 1989
Pediatric surgery international, Volume 4, pp 283-285; https://doi.org/10.1007/bf00177501

The publisher has not yet granted permission to display this abstract.
M. Ries, K-H Deeg
Published: 1 November 1994
Journal: Acta Paediatrica
Acta Paediatrica, Volume 83, pp 1228-1229; https://doi.org/10.1111/j.1651-2227.1994.tb18292.x

The publisher has not yet granted permission to display this abstract.
, Shih-Ming Chu, , Hsuan-Rong Huang, Chih-Cheng Luo
Published: 30 April 2009
Pediatrics & Neonatology, Volume 50, pp 59-64; https://doi.org/10.1016/s1875-9572(09)60034-6

Abstract:
Meconium peritonitis (MP) develops when bowel perforation occurs in utero or soon after birth, resulting in leakage of meconium into the peritoneal cavity. The clinical features are often variable and prenatal ultrasonography plays an important role in prenatal diagnosis.We conducted a retrospective review of neonates diagnosed with MP in our hospital from January 1998 to December 2007. Prenatal examinations, postnatal presentations, investigations, management, patient outcomes, and possible causes were analyzed.Ten patients (five boys, five girls) diagnosed with MP were studied. The most common prenatal ultrasonographic finding was fetal ascites (7/10, 70%), followed by polyhydramnios (3/10, 30%), bowel dilatation (3/10, 30%), intra-abdominal calcification (1/10, 10%), and hydrops fetalis (1/10, 10%). Two of our patients were completely normal on prenatal ultrasonography. Only one MP diagnosis (1/10, 10%) was definitely confirmed by prenatal ultrasonography due to the presence of ascites, bowel perforation and intra-abdominal calcification. Nine patients (90%) required surgical intervention because of bowel perforation (5), bowel atresia (2), obstruction due to ileus (1), and intussusception (1). Peritonitis was of cystic type in one case (10%), fibroadhesive in five cases (50%), and generalized in four cases (40%). All 10 patients survived without long-term gastrointestinal complications.Prenatal ultrasonography can be diagnostic for MP, which should be considered in the differential diagnosis of patients presenting with ascites or abdominal distension at birth. Close observation of postnatal clinical manifestations and timely surgical intervention resulted in a high survival rate and favorable outcome in these patients at our hospital.
, , R. Woderich, S. Kraft, R. Bollmann, H. Mau
Published: 1 November 2003
Prenatal Diagnosis, Volume 23, pp 904-908; https://doi.org/10.1002/pd.720

Abstract:
Objectives Intra‐uterine bowel perforation can occur secondary to a variety of abnormalities and cause sterile peritonitis in the fetus (generalised = type I). If sealing of the perforation does not take place, a thick‐walled pseudo‐cyst can form (type II). Methods Over a 12‐year period, 21 616 pregnancies were screened for gastro‐intestinal malformations using prenatal ultrasound. We identified 1077 cases suspicious of surgically correctable malformations. Post‐natal diagnoses and outcome were worked up retrospectively. Result We found 96 fetuses with suspected gastro‐intestinal malformations. Prenatal bowel perforation with meconium peritonitis was confirmed in 11 cases. In 5 of these 11, the correct diagnosis had been predicted prenatally. One child presented as a fetal and neonatal emergency (case report). Ten of the eleven infants were operated on during their first day of life. Intra‐operative findings were atresia (n = 4), meconium ileus (n = 6) and no obvious cause (n = 1). Two children suffered fatal complications. Conclusion Meconium peritonitis and meconium pseudo‐cysts as its special manifestation are assessable by prenatal diagnosis but present in different ways. They can present as fetal ascites or echogenic bowel and cause fetal or neonatal distress, requiring close observation and highly specialised care. Copyright © 2003 John Wiley & Sons, Ltd.
Ronald G. Frank, Steven C. Friedman, Alan Krieger, Perry S. Gerard, Kris Lindsay, Gilbert J. Wise
Published: 1 November 1991
Journal of Diagnostic Medical Sonography, Volume 7, pp 348-351; https://doi.org/10.1177/875647939100700606

Abstract:
Scrotal masses representing healed meconium peritonitis have been reported in the literature with increasing frequency. The first case of antenatal sonographic evidence of a paratesticular mass that was shown to represent healed meconium peritonitis at subsequent exploration is discussed in this report.
, Francesco Morini, Andrea Conforti
Published: 10 January 2020
The publisher has not yet granted permission to display this abstract.
Kinga Chalubinski, Josef Deutinger, Gerhard Bernaschek
Published: 1 August 1992
Prenatal Diagnosis, Volume 12, pp 631-636; https://doi.org/10.1002/pd.1970120802

The publisher has not yet granted permission to display this abstract.
Lee May Ping, Victor Samuel Rajadurai, , Suresh Chandran
Published: 21 September 2016
Fetal Diagnosis and Therapy, Volume 42, pp 57-62; https://doi.org/10.1159/000449380

Abstract:
Objective: To identify the fetal and neonatal imaging characteristics of meconium peritonitis (MP) and their clinical outcome. We also studied the role of prenatal ultrasound (US) in antenatal diagnosis and its use in predicting the need for surgical intervention postnatally. Material and Methods: We conducted a retrospective analysis of a cohort of 18 infants with MP from April 2004 to March 2014. Results: Prenatal US detected MP-related abnormalities in 15/18 (83.3%) fetuses. The median gestational age at initial diagnosis of MP was 24 weeks (range 19-31). Fetal ascites (93.3%) was the most common prenatal US finding. Of the 18 infants, 12 (66.7%) required surgical intervention. The overall survival rate was 94.4%. All infants with a prenatal US scan showing meconium pseudocyst or bowel dilatation required surgical intervention postnatally. Discussion: A combination of ascites, intraperitoneal calcification, and echogenic bowel on fetal US raises a high suspicion of MP. Surgical intervention is indicated in the presence of meconium pseudocyst on fetal or postnatal US scan. Antenatal US has high specificity (100%) but low sensitivity (22.2%) in detecting meconium pseudocyst. A favorable outcome can be expected with early antenatal diagnosis and timely surgical intervention in a tertiary hospital.
S. Venugopal, B. Shandling
Published: 1 December 1979
Journal of pediatric surgery, Volume 14, pp 715-718; https://doi.org/10.1016/s0022-3468(79)80252-3

Abstract:
During the 14 yr from 1965 through 1978, 49 infants presented shortly after birth with intestinal obstruction due to impacted meconium. Three of these patients did not have fibrocystic disease. Eight patients were cured by a Gastrografin enema. There were 18 patients who had complications that included associated atresia, volvulus, and/or peritonitis. Various operations were done including resection with either primary anastomosis or enterostomy or varieties of the foregoing. Twenty-three babies had the simple uncomplicated form of meconium ileus. Eleven of these underwent resection and six patients died. Twelve patients were treated by laparotomy, ileotomy through a purse-string suture and prolonged irrigations using acetylcysteine. Of this group only one succumbed. This latter course of management is recommended for patients with simple uncomplicated meconium ileus as it involves no resection, no enterostomy, nor any primary anastomosis.
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