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Articles » Gastrointestinal anomalies, spleen & abdominal wall » Meconium peritonitis

2001-05-08-21 Meconium peritonitis © Valero

Meconium peritonitis

Gloria Valero, MD, Philippe Jeanty, MD. PhD

These are 2 cases of meconium peritonitis. Case 1 was first seen in the second trimester, and had a normal examination. The mother was rescanned around 30 weeks 6 days pregnancy because she felt a decrease in fetal movements. The examination demonstrated distended loops of bowel that were not peristalsing properly. There was a small amount of peritoneal fluid and some calcifications, suggesting that pancreatic enzyme had been spilled and thus that cystic fibrosis was unlikely. Aside from the pictures there is also a 2 MB video clip. The diagnosis of meconium peritonitis was suggested. The baby had a rocky post-natal course that is written by the mom, in Gabby"s journey.

These are several views of the distended loops of bowel.








Case 2

This fetus was scanned at 30 weeks 3 days pregnancy for a clinical suspicion of increased growth and decreased fetal movements.

The fetus was at the 90th centile on the growth curve and the fluid was slightly increased.

There was a 70 by 50 by 40 mm anterior middle abdominal mass, below the umbilicus. This mass had a “bowel” appearance, but did not peristalse. Loops adjacent to this mass did peristalse. There was no ascites or polyhydramnios.

This was interpreted as most likely to represent a volvulus with a mass of twisted loops of bowel resulting in rupture and meconium peritonitis. After term delivery the child was operated and 25% of small bowels were resected. The child is doing fine 3 years later.





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