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Journal of Neonatal Surgery 2016
PubMed: 26793603
DOI: No ID Found -
Chirurgia (Bucharest, Romania : 1990) 2015Meconium peritonitis is a rare prenatal disease with an increased rate of morbidity and mortality in the neonatal period. Distinctive features revealed by prenatal and...
Meconium peritonitis is a rare prenatal disease with an increased rate of morbidity and mortality in the neonatal period. Distinctive features revealed by prenatal and postnatal ultrasoundmay be present: abdominal calcifications, ascites, polyhydramnios, meconium pseudocyst, echogenic mass and dilated bowel or intestinal obstruction. Establishing clear postnatal treatment and prognosis is difficult because of the heterogeneity of the results obtained by ultrasound. The aim of the study is to determine how prenatal diagnosis of meconium peritonitis is associated with perinatal management and further evolution. Clinical results are different depending on the presence of antenatal diagnosis of meconium peritonitis and its form, which can be mild or severe. Surgical treatment and management of meconium peritonitis depend on the clinical presentation of the newborn. Meconium peritonitis diagnosed prenatally differs from that of the newborn, not only concerning the mortality rates but also through reduced morbidity and overall better prognosis.
Topics: Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Peritonitis; Postnatal Care; Pregnancy; Prognosis; Retrospective Studies; Severity of Illness Index; Treatment Outcome; Ultrasonography, Prenatal
PubMed: 26713828
DOI: No ID Found -
Archivos Argentinos de Pediatria Dec 2015Meconium periorchitis is uncommon. In the unborn child the peritoneum vaginal canal is open and, secondary to intestinal perforation due to any cause (intestinal...
Meconium periorchitis is uncommon. In the unborn child the peritoneum vaginal canal is open and, secondary to intestinal perforation due to any cause (intestinal atresia, volvulus, and others), meconium peritonitis occurs. The intestinal content reaches the scrotal vaginal cavity. Meconium peritonitis can heal spontaneously and without consequences. Calcified remnants of this event may remain in the peritoneal cavity and/or scrotum. In the newborn, a hydrocele and scrotal mass can be observed; the ultrasound will show a heterogeneous image with calcifications. Meconium periorchitis or meconium vaginalitis resolves spontaneously. The lack of awareness of this disease could lead to unnecessary surgery in the newborn. We present a 33 days old patient with a scrotal mass in whom surgery was performed with the pathological diagnosis of meconium periorchitis.
Topics: Female; Humans; Infant, Newborn; Male; Meconium; Orchitis; Scrotum
PubMed: 26593810
DOI: 10.5546/aap.2015.e330 -
Case Reports in Obstetrics and... 2015Meconium periorchitis is a rare disorder caused by fetal meconium peritonitis, with subsequent passage of meconium into the scrotum via a patent processus vaginalis. To...
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.
PubMed: 26491584
DOI: 10.1155/2015/606134 -
BMJ Case Reports Jul 2015
Topics: Abdomen; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Meconium; Peritonitis; Radiography, Abdominal; Treatment Outcome
PubMed: 26153293
DOI: 10.1136/bcr-2015-211052 -
Journal of Neonatal Surgery 2014The purpose of this study is to review the cases of total colonic aganglionosis seen in the span of ten years at a pediatric surgery unit of a tertiary care public...
BACKGROUND
The purpose of this study is to review the cases of total colonic aganglionosis seen in the span of ten years at a pediatric surgery unit of a tertiary care public hospital in New Delhi.
METHODS
Medical records of twelve patients with total colonic aganglionosis were retrieved.
RESULTS
Ten out of the twelve patients were males; seven were of the Muslim community. Average recorded birth weight was 2.2 kg. Ten patients presented with features of intestinal obstruction, while two presented with perforation peritonitis. Among the cases of obstruction, Hirschsprung's disease was suspected in eight cases (one was associated with Shah-Waardenburg syndrome), one case each was preoperatively diagnosed as ileal atresia and meconium ileus. Abdominal X-rays at presentation of all the neonates except in one with Shah-Waardenburg syndrome showed multiple air fluid levels. Contrast enema was done in five patients. It showed micro-colon in two patients, and typical question mark sign, dilated small bowel with transition zone in hepatic flexure and normal caliber colon in one each. All the patients underwent exploratory laparotomy. Intra-operatively, the transition zone was seen at distal ileum in ten cases and at hepatic flexure and transverse colon in one each. Biopsies of all the twelve patients eventually showed absence of ganglion cells in entire colon. Ileostomy was done in nine cases, colostomy in two and primary Kimura's procedure in one (this patient was discharged and lost to follow up). Left colonic patch with Swenson's pull through with ileostomy was done for one patient on colostomy. His stoma was closed; he was eventually discharged and lost to follow up. In the other patient with colostomy, the stoma was closed and an ileostomy was created. Of all the patients on ileostomy, three expired in the immediate postoperative period. Four were lost to follow up. Two underwent Kimura's procedure; and expired few months later. One patient on ileostomy is awaiting further treatment.
CONCLUSION
The outcomes for total colonic aganglionosis in those presenting in neonatal age tend to be unsatisfactory in the developing countries.
PubMed: 26023499
DOI: No ID Found -
Intractable & Rare Diseases Research May 2015The aims of this study were to review our therapy and outcome for meconium peritonitis (MP) patients, and to clarify predictors of postoperative morbidity and mortality....
The aims of this study were to review our therapy and outcome for meconium peritonitis (MP) patients, and to clarify predictors of postoperative morbidity and mortality. We retrospectively reviewed a total 15 patients with MP who received surgical intervention at our institute from December 1990 to November 2012. Diagnosis of MP was confirmed by operative findings. We analyzed the relationship between outcome and patients' factors including patients' characteristics, prenatal diagnosis, type of MP, general condition, and surgical procedure. There was no relationship between outcome and the following factors: gender, gestational age, body weight at birth, delivery type, Apgar score, prenatal diagnosis, types and causes of MP, and surgical procedure. However, the preoperative presence of circulation deficiency and serum CRP values were statistically significant predictors of outcome in our MP patients. Prenatal diagnosis is essential for the first step of perinatal therapy for MP. Surgical strategy should be selected according to the information of prenatal diagnosis. Early surgical procedures to reduce systemic and abdominal inflammation just after birth may improve the outcome of severe MP cases.
PubMed: 25984428
DOI: 10.5582/irdr.2015.01011 -
Revista Paulista de Pediatria : Orgao... 2015To report a case of a preterm infant with complex meconium ileus at birth and cystic fibrosis.
OBJECTIVE:
To report a case of a preterm infant with complex meconium ileus at birth and cystic fibrosis.
CASE DESCRIPTION:
A male infant was born by vaginal delivery at 33 weeks and 5 days of gestational age with respiratory distress and severe abdominal distension. The exploratory laparotomy in the first day of life identified meconium ileus and secondary peritonitis. Ileal resection and ileostomy were performed, followed by reconstruction of the bowel transit at 20 days of life. At 11 days of life, the first immunoreactive trypsinogen (IRT) was 154 ng/mL (reference value = 70), and oral pancreatic enzymes replacement therapy was started. After 23 days, the second IRT was 172ng/mL (reference value = 70). At 35 days of age he was discharged with referrals to primary care and to a special clinic for CF for the determination of sweat chloride. He was received in the outpatient clinic for neonatal screening for CF at 65 days of life presenting malnutrition and respiratory distress. The sweat chloride test was performed, with a positive result (126mEq/L).
COMMENTS:
This case illustrates the rapid evolution of CF in a premature patient with complex meconium ileus as the first clinical manifestation.
Topics: Cystic Fibrosis; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intestinal Obstruction; Male; Meconium
PubMed: 25887928
DOI: 10.1016/j.rpped.2014.12.004 -
Pediatric Gastroenterology, Hepatology... Dec 2014Severe combined immunodeficiency (SCID) is a life-threatening syndrome of recurrent infections and gastrointestinal alterations due to severe compromise of T cells and B...
Severe combined immunodeficiency (SCID) is a life-threatening syndrome of recurrent infections and gastrointestinal alterations due to severe compromise of T cells and B cells. Clinically, most patients present symptoms before the age of 3 months and without intervention SCID usually results in severe infections and death by the age of 2 years. Its association with intestinal anomalies as multiple intestinal atresias (MIA) is rare and worsens the prognosis, resulting lethal. We describe the case of a four year-old boy with SCID-MIA. He presented at birth with meconium peritonitis, multiple ileal atresias and underwent several intestinal resections. A targeted Sanger sequencing revealed a homozygous 4-bp deletion (c.313ΔTATC; p.Y105fs) in tetratricopeptide repeat domain 7A (TTC7A). He experienced surgical procedures including resection and stricturoplasty. Despite parenteral nutrition-associated liver disease, the patient is surviving at the time of writing the report. Precocious immune system assessment, scrutiny of TTC7A mutations and prompt surgical procedures are crucial in the management.
PubMed: 25587526
DOI: 10.5223/pghn.2014.17.4.257 -
Ultrasound in Obstetrics & Gynecology :... Apr 2015
Topics: Adult; Female; Fetal Diseases; Humans; Imaging, Three-Dimensional; Infant, Newborn; Infant, Newborn, Diseases; Inflammatory Bowel Diseases; Meconium; Meconium Aspiration Syndrome; Peritonitis; Pregnancy; Ultrasonography, Prenatal
PubMed: 25565652
DOI: 10.1002/uog.14778