-
Journal of Pediatric Surgery Aug 2022Meconium peritonitis (MP) is a sterile, chemical peritonitis resulting from in-utero fetal bowel perforation. Severe cases may lead to serious morbidities and... (Review)
Review
BACKGROUND
Meconium peritonitis (MP) is a sterile, chemical peritonitis resulting from in-utero fetal bowel perforation. Severe cases may lead to serious morbidities and mortalities.
OBJECTIVE
To review the common antenatal ultrasound abnormalities associated with MP, and identify radiological and clinical prognostic factors.
MATERIALS AND METHODS
Retrospective review of all neonates with MP from January 1997 to December 2019 treated in our hospital was performed. Antenatal ultrasound findings, clinical presentations and outcomes were analyzed.
RESULTS
Thirty-five neonates (17 males, 18 females) were included in the study. Thirty-two (91.4%) attended antenatal screening, and 27 (84.4%) of them had abnormalities identified on antenatal ultrasound. The most common abnormality was polyhydramnios (43.8%). Nineteen (54.3%) patients were inborn. Twenty (57.1%) patients were born prematurely. Laparotomy was required in 85.7% of patients. The median time to laparotomy was shorter in the inborn group [1 day (0-9 days) vs 4 days (2-34 days), p = 0.001], but the duration of post-operative hospital stay was comparable [71 days (16-423 days) vs 73.5 days (23-231 days)]. However, such duration was found to be significantly longer in the pre-term group when compared to full-term [58.5 days (16-89 days) vs 85 (21-423 days), p = 0.01]. The most common pathology was small bowel atresia and there were two mortalities.
CONCLUSION
Due to the advancement in prenatal detection, pediatric anesthesia, intensive care and surgical techniques, the morbidity and mortality of MP has much decreased. Effective multi-disciplinary antenatal counseling facilitated the perinatal management of MP and resulted in comparable prognosis and outcome in inborn and outborn neonates.
Topics: Child; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Tertiary Care Centers; Ultrasonography, Prenatal
PubMed: 34794810
DOI: 10.1016/j.jpedsurg.2021.10.006 -
Journal of the College of Physicians... Jan 2019
Topics: Humans; Infant, Newborn; Male; Ascites; Fatal Outcome; Ileum; Intestinal Perforation; Meconium; Peritonitis; Respiratory Distress Syndrome, Newborn; Female; Cesarean Section
PubMed: 30630586
DOI: 10.29271/jcpsp.2019.01.97 -
Journal of Perinatology : Official... 2000Meconium peritonitis can have a wide range of presentations. This report discusses two cases that have recently appeared in our neonatal intensive care unit. The first...
Meconium peritonitis can have a wide range of presentations. This report discusses two cases that have recently appeared in our neonatal intensive care unit. The first report discusses the case of a meconium pseudocyst in a preterm infant. The second case reports on a newborn baby with a healed bowel perforation during the prenatal period. Finally, a brief discussion of meconium peritonitis is also included.
Topics: Adult; Colonic Diseases; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Laparotomy; Meconium; Peritonitis; Pregnancy; Pregnancy Complications; Radiography, Abdominal; Ultrasonography, Prenatal
PubMed: 10802847
DOI: 10.1038/sj.jp.7200287 -
BMC Pediatrics May 2018Meconium peritonitis is an infrequent congenital disease usually caused by perforation of the fetal digestive tract. Meconium peritonitis resulting from intrauterine... (Review)
Review
BACKGROUND
Meconium peritonitis is an infrequent congenital disease usually caused by perforation of the fetal digestive tract. Meconium peritonitis resulting from intrauterine appendiceal perforation has been rarely reported and is often overlooked during pregnancy. We herein report two cases of fetal appendiceal perforation.
CASE PRESENTATION
Two neonates were found to have intestinal distension and gradually increasing ascites antenatally. After birth, diagnostic abdominal punctures revealed meconium peritonitis. Urgent surgery showed both neonates had developed gangrenous appendicitis in utero. Pathological examination supported the diagnosis of fetal appendiceal perforation in both neonates, and one also had deformity of cecal duplication. In the present report, we also review the presentation, diagnosis, pathology, management, and recent literature of fetal appendiceal perforation.
CONCLUSION
Meconium peritonitis due to fetal appendiceal perforation is extremely rare, and preoperative diagnosis is almost impossible. However, clinicians should be aware of abnormal gastrointestinal manifestations in the fetus during the antenatal examination. For neonates with severe meconium peritonitis, an early operation with careful intraoperative exploration is necessary.
Topics: Appendicitis; Cecum; Humans; Infant, Newborn; Male; Meconium; Peritonitis
PubMed: 29751786
DOI: 10.1186/s12887-018-1133-8 -
Surgery Aug 1966
Topics: Ascites; Cysts; Female; Humans; Infant; Intestinal Obstruction; Laparotomy; Male; Meconium; Peritonitis
PubMed: 5920370
DOI: No ID Found -
Journal of the Medical Association of... Nov 1999Meconium peritonitis is an unusual and often fatal form of neonatal peritonitis characterized by intraperitoneal calcification, numerous fibrosis with or without...
Meconium peritonitis is an unusual and often fatal form of neonatal peritonitis characterized by intraperitoneal calcification, numerous fibrosis with or without pseudocyst formation due to antenatal extravasation of meconium. This report is a retrospective study of 32 pediatric patients who were treated at the Surgical Department of the Children's Hospital from 1987 to 1996. The purposes of this study emphasize clinical manifestations, radiological findings, operative procedures and results of treatment. Twenty seven were neonates and five were older infants. The most common clinical presentation was abdominal distension at birth. The abdominal X-rays showed abnormal calcification and mass lesion in the peritoneal cavity in 71.9 and 46.9 per cent respectively. Only one patient was not treated surgically because he had no evidence of gut obstruction and inflammation. Thirty-one patients were operated on. At laparotomy, all of them had numerous inflammatory adhesion bands and matted bowel loops. Giant pseudocysts and intestinal perforations were noted in 64.5 and 54.8 per cent respectively. The obvious causes of meconium peritonitis were ileal atresia in 4, jejunal atresia in 3 and appendiceal perforation in 1. In the other 23 patients, no apparent cause of perforation was noted. Only lysis of the adhesion with or without drainage was done in 9 patients and one of these died. Partial resection of pseudocysts and exteriorization of the perforated bowel were done in 10 patients and 2 of these babies died. Primary anastomosis after resection of the perforated bowel was done in 12 patients and 5 of these cases died. The overall survival rate was 75 per cent. Our data from this study suggested that partial resection of the pseudocyst and temporary enterostomy should be done in cases with bowel perforation and severe meconium contamination. Early diagnosis, proper operative procedure and meticulous postoperative care offer the best opportunity for survival of patients with meconium peritonitis.
Topics: Female; Humans; Infant; Infant, Newborn; Male; Meconium; Peritonitis; Prognosis; Retrospective Studies; Treatment Outcome
PubMed: 10659538
DOI: No ID Found -
Computational Intelligence and... 2022To explore the prenatal ultrasonographic characteristics and pregnancy outcomes of fetal meconium peritonitis (FMP).
OBJECTIVE
To explore the prenatal ultrasonographic characteristics and pregnancy outcomes of fetal meconium peritonitis (FMP).
METHODS
Nine patients diagnosed with FMP by routine prenatal examination between January 2015 and December 2020 were identified. Both prenatal ultrasonographic characteristics and pregnancy outcomes associated with these patients were retrospectively analyzed.
RESULTS
The mean gestational age at the time of FMP diagnosis was 31.3 ± 4.8 weeks, and the mean gestational age of delivery was 35.1 ± 5.1 weeks. Prenatal ultrasonographic findings at the time of diagnosis in these patients included intestinal dilatation (9/9, 100%), intraperitoneal calcification (8/9, 88.9%), fetal ascites (5/9, 55.6%), intraperitoneal pseudocyst (5/9, 55.6%), and polyhydramnios (6/9, 66.7%). Analyses of the etiological basis for meconium peritonitis in 5 of the 8 live births that underwent surgical treatment revealed 4 cases of congenital volvulus and 1 case of jejunal atresia.
CONCLUSION
The prenatal ultrasound manifestations of fetal meconium peritonitis are diverse, and the different grades of prenatal ultrasound manifestations can provide important information for the treatment of perinatal infants.
Topics: Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Pregnancy Outcome; Retrospective Studies; Ultrasonography, Prenatal
PubMed: 35669660
DOI: 10.1155/2022/8658999 -
Journal of Neonatal-perinatal Medicine 2016We 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... (Review)
Review
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.
Topics: Cystic Fibrosis; Diagnosis, Differential; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Orchiectomy; Orchitis; Peritonitis; Radiography, Abdominal; Scrotum; Testicular Diseases; Testis
PubMed: 27002270
DOI: 10.3233/NPM-16915067 -
Radiology Dec 1987Ultrasonographic (US) findings were correlated with clinical outcome in seven cases of meconium peritonitis detected with prenatal US during a 2-year period. Nineteen... (Review)
Review
Ultrasonographic (US) findings were correlated with clinical outcome in seven cases of meconium peritonitis detected with prenatal US during a 2-year period. Nineteen previously reported cases were also reviewed. US findings included intraabdominal calcifications (n = six cases), fetal ascites (n = 3), echogenic ascites without calcifications (n = 1), bowel dilatation (n = 2), and polyhydramnios (n = 5). Following delivery, six infants were still alive after a mean follow-up of 13 months (range, 6-26 months); the seventh died of hydrocephalus. Of the six, four required surgical correction of a small-bowel perforation and two did not. All six are thriving, and none has yet been found to have cystic fibrosis. In the 19 previously reported cases, there were only two cases of cystic fibrosis, neither with intraabdominal calcifications. The presence of calcifications was significantly associated with causes other than cystic fibrosis. Prenatally diagnosed cases of meconium peritonitis are associated with cystic fibrosis less frequently than previous studies suggest.
Topics: Ascites; Calcinosis; Cystic Fibrosis; Female; Fetal Diseases; Follow-Up Studies; Humans; Infant, Newborn; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Pregnancy Outcome; Prenatal Diagnosis; Ultrasonography
PubMed: 3317498
DOI: 10.1148/radiology.165.3.3317498 -
Annals of Surgery Apr 1951
Topics: Humans; Infant, Newborn; Meconium; Peritonitis
PubMed: 14819993
DOI: 10.1097/00000658-195104000-00015