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BMC Pediatrics Mar 2020Meconium peritonitis is defined as aseptic chemical inflammation caused by intrauterine bowel perforation. The underlying causes of bowel perforation include intestinal...
BACKGROUND
Meconium peritonitis is defined as aseptic chemical inflammation caused by intrauterine bowel perforation. The underlying causes of bowel perforation include intestinal atresia, midgut volvulus, intussusception, congenital bands, and meconium ileus.
CASE PRESENTATION
Siblings with prenatally diagnosed meconium peritonitis of different etiologies were found. The elder sister was born at 36 + 6 weeks gestation with a birth weight of 3110 g. She was diagnosed with meconium peritonitis caused by ileal atresia. Two years later, the younger brother was born at 34 + 3 weeks gestation with a birth weight of 2850 g. He was diagnosed with meconium peritonitis caused by midgut volvulus.
CONCLUSIONS
Among the previously reported cases of meconium peritonitis, familial occurance of meconium peritonitis is extremely rare. We present a case of prenatally diagnosed meconium peritonitis in siblings to promote further understanding of its etiology and clinical course.
Topics: Cesarean Section; Female; Humans; Infant, Newborn; Intestinal Atresia; Intestinal Volvulus; Male; Meconium; Peritonitis; Pregnancy; Siblings
PubMed: 32138710
DOI: 10.1186/s12887-020-2016-3 -
European Journal of Pediatric Surgery... Jan 2020We report on a male preterm newborn with a large abdominal tumor found on prenatal ultrasound 2 weeks prior to delivery at 36 + 0 weeks of gestation. A postnatal...
We report on a male preterm newborn with a large abdominal tumor found on prenatal ultrasound 2 weeks prior to delivery at 36 + 0 weeks of gestation. A postnatal abdominal plain film showed a mass with well-defined rim calcifications ("eggshell"), suggestive of a meconium pseudocyst. On the 4th day of life, the boy underwent exploratory laparotomy with resection of the cyst and end-to-back jejunojejunostomy. The postoperative course was uneventful. A meconium pseudocyst is the correlate of a sterile peritonitis caused by antenatal bowel perforation. It is an easily recognizable spot diagnosis any pediatrician and pediatric surgeon should be aware of.
PubMed: 31998597
DOI: 10.1055/s-0039-3399556 -
Indian Journal of Pediatrics May 2020
Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Tuberculosis, Pulmonary
PubMed: 31897881
DOI: 10.1007/s12098-019-03149-2 -
Journal of Medical Ultrasound 2019Hydrops fetalis in association with meconium peritonitis is a rare condition, and the mechanism underlying hydropic changes has not been fully recognized. We present a...
Hydrops fetalis in association with meconium peritonitis is a rare condition, and the mechanism underlying hydropic changes has not been fully recognized. We present a case of fetal meconium peritonitis with hydrops and coagulopathy. Clinically, the cause of fetal disseminated intravascular coagulation is considered to be a consequence of a systematic inflammatory response based on progressive, but mild fetal anemia without other apparent triggers, thrombocytopenia, elevated white blood cell count and serum C reactive-protein, hypoalbuminemia, and increased vascular permeability. The infant was born at 32 weeks of gestation and survived after postnatal multidisciplinary treatment. Our experience suggests that recognition of this rare condition will enable early diagnosis and better clinical management for fetuses with meconium peritonitis.
PubMed: 31867196
DOI: 10.4103/JMU.JMU_25_19 -
BMC Pediatrics Dec 2019In the last century, meconium peritonitis(MP)was once a highly fatal gastrointestinal. disease With the development of fetal radiological technology, abnormal signs,...
BACKGROUND
In the last century, meconium peritonitis(MP)was once a highly fatal gastrointestinal. disease With the development of fetal radiological technology, abnormal signs, such as pseudocysts, can. be detected during the fetal period so that more patients can be diagnosed prenatally and receive surgery. in the early stage of life. The survival rate of MP has increased up to 80% in recent years. According to. a review of the treatment and outcomes of patients diagnosed with MP, we evaluated the influence of. early operation on survival rate and discussed the risk factors of prognosis.
METHODS
We collected 79 cases of patients diagnosed with MP who were treated in our department. from October 2001 to December 2017. They were divided into 2 groups. Patients in group A were born. in our hospital. Patients in group B were born in a local hospital with suspicion of MP and then transferred. to our department.
RESULTS
The birth weight (BW) and gestational age (GA) of patients were higher in group A than in. group B. There was no significant difference in the proportion of premature and low birth weight (LBW). patients between the two groups (p = 0.422, p = 0.970). Their age at the time of surgery was younger in. group A than in group B (1.4 ± 2.0 vs. 6.9 ± 14.9, p < 0.001). The overall survival rate of group A was higher. than that of group B (95.0% vs. 79.5%, p = 0.038). The prognosis of premature patients was worse than. that of full-term infants for both groups (p = 0.012).
CONCLUSIONS
Prematurity is a significant risk factor related to death for MP patients. The survival rate. of MP patients can be improved by early operation during the neonatal period.
Topics: Female; Follow-Up Studies; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intestinal Perforation; Magnetic Resonance Imaging; Male; Meconium; Peritonitis; Prenatal Diagnosis; Prognosis; Retrospective Studies; Survival Rate; Time-to-Treatment; Ultrasonography, Prenatal
PubMed: 31795969
DOI: 10.1186/s12887-019-1844-5 -
Pediatric Gastroenterology, Hepatology... Nov 2019Meconium peritonitis as a cause of non-immune hydrops in neonates is rarely reported. Here we report such a rare occurrence. In our case, a routine antenatal scan at 25...
Meconium peritonitis as a cause of non-immune hydrops in neonates is rarely reported. Here we report such a rare occurrence. In our case, a routine antenatal scan at 25 weeks revealed isolated ascites. By 31 weeks of gestation, all features of hydrops were observed in scans. However, antenatal workup for immune and non-immune hydrops was negative. Subsequently, a preterm hydropic female baby was delivered at 32 weeks. She required intubation and ventilator support. An X-ray revealed calcification in the abdomen suggestive of meconium peritonitis. Ultrasound showed gross ascites, a giant cyst compressing the inferior vena cava, and minimal bilateral pleural effusion. Emergency laparotomy revealed meconium pellets and perforation of the ileum. Double-barrel ileostomy was performed, and the edema resolved and activity improved. The baby was discharged after 3 weeks. Ileostomy closure was done at follow-up. The baby is growing well.
PubMed: 31777724
DOI: 10.5223/pghn.2019.22.6.576 -
Prenatal Diagnosis Feb 2020The objective of this study is to determine factors associated with poor outcomes and the need for surgical treatment in neonates with meconium peritonitis (MP).
OBJECTIVE
The objective of this study is to determine factors associated with poor outcomes and the need for surgical treatment in neonates with meconium peritonitis (MP).
METHODS
We evaluated the association between prenatal ultrasound features, maternal characteristics, and the likelihood of surgery, mortality, and serious morbidity in 49 neonates with a prenatal diagnosis of MP, who were born in Guangzhou Women and Children's Medical Center between January 2011 and December 2016.
RESULTS
Thirty of 49 neonates (61.2%) required surgical treatment, and 17 (34.7%) had a poor outcome. Independent predictors of need for surgical treatment were polyhydramnios, maternal intrahepatic cholestasis of pregnancy (associated with lower risk), and persistence of peritoneal fluid. The model correctly predicted 70.0% of the neonates who required surgery (at a 10% false-positive rate; area under the curve [AUC]: 0.86 [95% CI, 0.75-0.97]). For poor outcomes, independent predictors were low gestational age at birth, persistence of peritoneal fluid, and polyhydramnios. For the latter, the model only achieved a detection rate of 52.9% (10% false-positive rate, AUC: 0.82 [95% CI, 0.70-0.94]).
CONCLUSIONS
A combination of prenatal ultrasound features and maternal characteristics correctly predicted 70.0% the need for neonatal surgery. Prediction of poor outcome-based prenatal ultrasound features and gestational age did not perform well.
Topics: Adult; Cesarean Section; China; Cholestasis, Intrahepatic; Female; Gestational Age; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Complications; Retrospective Studies; Treatment Outcome; Ultrasonography, Prenatal
PubMed: 31713898
DOI: 10.1002/pd.5608 -
Medicine Sep 2019Advancements in diagnostic modalities have improved the diagnosis of meconium peritonitis (MP) both in utero and ex utero. This study aimed to determine the efficacy of... (Comparative Study)
Comparative Study Observational Study
Advancements in diagnostic modalities have improved the diagnosis of meconium peritonitis (MP) both in utero and ex utero. This study aimed to determine the efficacy of prompt prenatal and postnatal diagnoses of MP on the postnatal outcomes of these patients.We conducted a retrospective chart review of neonates with MP admitted to the Mackay Memorial Hospital Systems from 2005 to 2016. The prenatal diagnoses, postnatal presentations, surgical indications, operative methods, types of MP, operative findings, associated anomalies, morbidities, patient outcomes, and survival rates were analyzed. Morbidities included postoperative adhesion ileus, bacteremia, and short bowel syndrome. We also performed subgroup analyses of the morbidity and survival rates of prenatally versus postnatally diagnosed patients, as well as inborn versus outborn neonates.Thirty-seven neonates with MP were enrolled. Of this number, 24 (64.9%) were diagnosed prenatally. Twenty-two (59.5%) were born preterm. The most common prenatal sonographic findings included fetal ascites followed by dilated bowel loops. Abdominal distention was the most frequent postnatal symptom. Thirty-four (91.9%) neonates underwent surgery, whereas 3 were managed conservatively. Volvulus of the gastrointestinal tract was the most frequent anatomic anomaly. The total morbidity and survival rates were 37.8% and 91.9%, respectively. The morbidity and survival rates did not differ significantly between prenatally and postnatally diagnosed patients (37.5% vs 33.3%, P = 1.00; 91.7% vs 92.3%, P = 1.00, respectively). Inborn and outborn patients did not differ in terms of morbidity and survival rates (27.3% vs 53.3%, P = .17; 100% vs 80.0%, P = .06, respectively).Although not statistically significant, inborn MP neonates had higher survival rates when compared with outborn MP neonates. Prompt postnatal management at tertiary centers seemed crucial.
Topics: Ascites; Dilatation, Pathologic; Early Diagnosis; Female; Humans; Infant, Newborn; Intestinal Volvulus; Intestines; Meconium; Patient Outcome Assessment; Peritonitis; Pregnancy; Retrospective Studies; Survival Rate; Time-to-Treatment; Ultrasonography, Prenatal
PubMed: 31574807
DOI: 10.1097/MD.0000000000017079 -
Cirugia Pediatrica : Organo Oficial de... Jul 2019To assess the importance of prenatal ultrasound diagnosis of the fetus carrying meconium periorchitis and its predictive relevance for fetal monitoring and prognosis in... (Review)
Review
OBJECTIVE
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.
MATERIAL AND METHODS
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.
RESULTS
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.
CONCLUSION
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.
Topics: Adult; Female; Gestational Age; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Orchitis; Pregnancy; Ultrasonography, Prenatal; Young Adult
PubMed: 31486310
DOI: No ID Found -
Fetal and Pediatric Pathology Feb 2020Meconium peritonitis (MP) is an infrequent prenatal complication. Association between MP and pulmonary hypoplasia has never been reported. A female infant with...
Meconium peritonitis (MP) is an infrequent prenatal complication. Association between MP and pulmonary hypoplasia has never been reported. A female infant with antenatally diagnosed MP and ascites was delivered at 36 gestational weeks. She died shortly after birth due to pulmonary insufficiency. Autopsy confirmed the presence of MP and ascites, and additionally revealed intestinal malrotation, volvulus, necrosis and perforation, and pulmonary hypoplasia. Congenital cytomegalovirus (CMV) infection was also noted. This was an unexpected finding as the mother was tested negative for CMV IgM at 26 gestational weeks after sonographic detection of fetal ascites. This is the first reported case of lethal pulmonary hypoplasia in a neonate with MP-associated ascites complicated by congenital CMV infection. This case illustrates that a negative maternal CMV IgM might not be sufficient to rule out congenital CMV, and that a concomitant infectious etiology should always be considered even when a primary cause for fetal ascites (e.g., MP in this case) is identified.
Topics: Adult; Cytomegalovirus Infections; Digestive System Abnormalities; Female; Gestational Age; Humans; Infant, Premature, Diseases; Intestinal Volvulus; Meconium; Peritonitis; Respiratory System Abnormalities; Ultrasonography, Prenatal
PubMed: 31198083
DOI: 10.1080/15513815.2019.1627631