morphine and Peritonitis

Meconium peritonitis (MP) is a sterile, chemical peritonitis resulting from in-utero fetal bowel perforation. Severe cases may lead to serious morbidities and mortalities.. To review the common antenatal ultrasound abnormalities associated with MP, and identify radiological and clinical prognostic factors.. 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.. 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.. 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

 To describe the postnatal outcome of fetal meconium peritonitis and identify prenatal predictors of neonatal surgery..  We retrospectively reviewed all fetuses with ultrasound findings suspicious for meconium peritonitis at a single center over a 10-year period. A systematic review and meta-analysis were then performed pooling our results with previous studies assessing prenatally diagnosed meconium peritonitis and postnatal outcome. Prenatal sonographic findings were analyzed to identify predictors for postnatal surgery..  34 cases suggestive of meconium peritonitis were diagnosed at our center. These were pooled with cases from 14 other studies yielding a total of 244 cases. Postnatal abdominal surgery was required in two thirds of case (66.5 %). The strongest predictor of neonatal surgery was meconium pseudocyst (OR [95 % CI] 6.75 [2.53-18.01]), followed by bowel dilation (OR [95 % CI] 4.17 [1.93-9.05]) and ascites (OR [95 % CI] 2.57 [1.07-5.24]). The most common cause of intestinal perforation and meconium peritonitis, found in 52.2 % of the cases, was small bowel atresia. Cystic fibrosis was diagnosed in 9.8 % of cases. Short-term neonatal outcomes were favorable, with a post-operative mortality rate of 8.1 % and a survival rate of 100 % in neonates not requiring surgery..  Meconium pseudocysts, bowel dilation, and ascites are prenatal predictors of neonatal surgery in cases of meconium peritonitis. Fetuses with these findings should be delivered in centers with pediatric surgery services. Though the prognosis is favorable, cystic fibrosis complicates postnatal outcomes.. ZIEL:  Beschreibung des postnatalen Outcomes der fetalen Mekoniumperitonitis und Identifizierung pränataler Prädiktoren für die neonatale Chirurgie..  Wir untersuchten an einem einzigen Zentrum über 10 Jahre hinweg retrospektiv alle Föten mit Ultraschallbefunden, bei denen der Verdacht einer Mekoniumperitonitis bestand. Eine systematische Übersicht und eine Metaanalyse wurden daraufhin durchgeführt, um unsere Ergebnisse mit früheren Studien zur Beurteilung der pränatalen Mekoniumperitonitis und des postnatalen Outcomes zusammenzufassen. Die pränatalen sonografischen Befunde wurden analysiert, um Prädiktoren für die postnatale Chirurgie zu identifizieren..  In unserem Zentrum gab es 34 Fälle mit Verdachtsdiagnose Mekoniumperitonitis. Diese wurden mit Fällen aus 14 anderen Studien zusammengefasst, sodass sich insgesamt 244 Fälle ergaben. In 2 Drittel der Fälle (66,5 %) war eine postnatale abdominale Operation erforderlich. Der stärkste Prädiktor für die neonatale Chirurgie war eine Mekonium-Pseudozyste (OR 6,75; 95 %-KI 2,53–18,01), gefolgt von Darmdilatation (OR 4,17; 95 %-KI 1,93–9,05) und Aszites (OR 2,57; 95 %-KI 1,07–5,24). Die häufigste Ursache für Darmperforation und Mekoniumperitonitis, die in 52,2 % der Fälle gefunden wurde, war die Dünndarmatresie. Mukoviszidose wurde in 9,8 % der Fälle diagnostiziert. Das Kurzzeit-Outcome bei Neugeborenen war günstig, mit einer postoperativen Mortalitätsrate von 8,1 % und einer Überlebensrate von 100 % bei Neugeborenen, die nicht operiert werden mussten..  Mekonium-Pseudozysten, Darmdilatation und Aszites sind pränatale Prädiktoren für eine neonatale Chirurgie bei Mekoniumperitonitis. Bei Föten mit diesen Befunden sollte die Entbindung in Zentren mit dem Schwerpunkt Neugeborenenchirurgie erfolgen. Obwohl die Prognose günstig ist, erschwert Mukoviszidose das postnatale Outcome.

Topics: Child; Female; Humans; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis; Pregnancy; Retrospective Studies; Ultrasonography, Prenatal

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.. 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.. 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

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

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.

Topics: Female; Humans; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Intestine, Small; Meconium; Peritonitis

Topics: Diagnosis, Differential; Female; Fetal Diseases; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Prognosis

Generalized arterial calcification of infancy (GACI) is a rare genetic disorder consisting of diffuse arterial calcification and intimal proliferation. The disease typically results in progressive arterial stenosis and frequently leads to death from myocardial ischemia by 6 months of life. Affected infants are usually diagnosed before birth or in the neonatal period with symptoms of congestive heart failure. Therapy with bisphosphonate has been used to treat the condition, but with inconsistent results. The disease is associated with mutations in ENPP1 in the majority of the cases. Here we report a unique case of GACI associated with in utero meconium peritonitis and without coding region mutations of the ENPP1 gene. GACI should be considered in the differential diagnosis in infants presenting with arterial calcifications and congenital anomalies of the gastrointestinal tract.

Topics: Abnormalities, Multiple; Adult; Aortic Diseases; Calcinosis; Clubfoot; Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Phosphoric Diester Hydrolases; Pyrophosphatases; Scoliosis; Ultrasonography, Prenatal

Meconium peritonitis (MP) is defined as a sterile inflammatory reaction in the fetal abdomen that is seen in cases of intrauterine bowel perforation. Recently, there have been increasing numbers of fetuses with MP prenatally diagnosed by ultrasonography. Massive fetal ascites in MP may cause hydrops and hypoplastic lungs. However, antepartum management of MP has not yet been established. We encountered a fetus with MP and massive ascites. Repeated paracentesis between 29 weeks and 4 days and 31 weeks and 6 days of gestation prevented the progression to fetal hydrops and hypoplastic lungs, which may occur due to massive meconium ascites with an increased preload index. Amniocentesis was also performed in patients with polyhydramnios for treatment of preterm labor. These observations suggest that aggressive therapy can prolong the gestation period and improve MP treatment outcomes.

Topics: Adult; Ascites; Female; Fetal Diseases; Gestational Age; Humans; Ileal Diseases; Infant; Intestinal Perforation; Labor, Induced; Live Birth; Male; Meconium; Paracentesis; Peritonitis; Pregnancy; Reoperation; Ultrasonography, Doppler, Color; Ultrasonography, Doppler, Pulsed; Ultrasonography, Prenatal

The management of a case of antenatally diagnosed meconium peritonitis (MP) due to intrauterine intestinal perforation secondary to bowel atresia is reported. The literature is reviewed with reference to the significance and outcome of antenatally diagnosed MP.

Topics: Adult; Female; Humans; Infant, Newborn; Intestinal Atresia; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis

A case is presented in which extension of meconium peritonitis through muscular defects in the diaphragm lead to intrathoracic calcifications diagnosed sonographically at 23 weeks of gestation. There were three diaphragmatic defects, two small ones corresponded to foramina of Morgagni and one large posterior defect that did not correspond to the foramen of Bochdelak. There were three additional muscular defects: one in the rectus abdominus and two, bilaterally, in the loins. Despite long-standing fetal ascites and fresh intraperitoneal meconium at laparotomy, postoperative progress was uneventful. The baby did not have other dysmorphic features except for a single palmar crease, the chromosomes were normal, and the baby did not have cystic fibrosis. Follow-up examination at 10 months showed a thriving infant with mild hypotonia and developmental delay, but no respiratory or gastrointestinal problems.

Topics: Adult; Calcinosis; Cesarean Section; Chromosome Aberrations; Chromosome Disorders; Female; Hernia, Diaphragmatic; Humans; Ileal Diseases; Infant, Newborn; Intestinal Perforation; Laparotomy; Male; Meconium; Peritonitis; Pregnancy; Thoracic Diseases; Tomography, X-Ray Computed; Ultrasonography

Maternal peritonitis secondary to fetal vernix caseosa is considered an infrequent complication of cesarean section in which commonly spilled amniotic fluid is incompletely lavaged. Nine of the 10 reported cases have been diagnosed in the postpartum period after an uneventful cesarean section. Characteristically, vernix elicits granulomatous inflammation, occasionally with a mass lesion simulating bowel perforation and leading to colectomy. One case of antenatal leakage of amniotic fluid has been reported, also with granulomatous inflammation. We report two additional cases of antenatal leakage, both with acute inflammation lacking granulomatous features or mass lesions. The interval between amniotic fluid contamination and histopathologic evaluation is the basis for variations in the inflammatory pattern.

Topics: Adult; Amniotic Fluid; Cesarean Section; Fallopian Tubes; Female; Foreign-Body Reaction; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Vernix Caseosa

We present a case of meconium peritonitis which was associated with a short bowel and complicated by progressive bowel distension and difficulty in making a definitive diagnosis of cystic fibrosis. Treatment was by bowel resection and an ileostomy (and later bowel anastomosis), followed by parenteral nutrition which was complicated by hepatitis. The literature is reviewed and management dilemmas and options are discussed.

Topics: Adult; Cystic Fibrosis; Female; Fetal Diseases; Humans; Ileostomy; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Karyotyping; Male; Meconium; Parenteral Nutrition; Peritonitis; Polyhydramnios; Pregnancy; Ultrasonography, Prenatal

A case of meconium peritonitis that was diagnosed ultrasonographically in the third trimester is presented. Fetal ascites, intra-abdominal calcification, left communicating hydrocele, and polyhydramnios were detected on antenatal ultrasonography. Specks of calcification were also demonstrated on abdominal radiography postnatally. Laparotomy confirmed the diagnosis of perforated terminal ileum with meconium peritonitis. The obstetric and neonatal implications of meconium peritonitis are discussed with literature review.

Topics: Adult; Female; Fetal Diseases; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Ultrasonography, Prenatal

A case of meconium peritonitis that was diagnosed ultrasonographically in the second trimester is presented. Fetal ascites, intraabdominal calcification and polyhydramnios were detected on antenatal ultrasonography. Specks of calcification were also demonstrated on abdominal radiography postnatally. The obstetric and neonatal implications of meconium peritonitis are discussed with literature review.

Topics: Adult; Ascites; Calcinosis; Female; Fetal Diseases; Humans; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Ultrasonography, Prenatal

Fetal intestinal perforation causes a sterile inflammatory reaction of the peritoneum called meconium peritonitis. Twelve patients studied in the perinatal period serve to describe the classical fetal and neonatal signs and symptoms, the iconographical findings, treatment and prognosis. All but one infant, with a meconium pseudocyst, presented with the fibro-adhesive variety. Two were caused by cystic fibrosis, two by organic obstruction, one by fetal appendicitis and another two by ischemic necrosis of part of the ileum. In one of the latter two, the probable mechanism was feto-fetal embolisation following the in utero death of a co-twin. One idiopathic perforation, diagnosed in a preterm infant, healed spontaneously. The neonatal mortality rate was 18%. Primary enteric anastomosis was feasible in 3, Bishop-Koop anastomosis in 2 and an intestinal stoma in two others. Apart from the two survivors with cystic fibrosis, seven have no late gastro-intestinal sequelae.

Topics: Female; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Prenatal Diagnosis; Tissue Adhesions

A rare case of a newborn infant with leiomyosarcoma of the transverse colon is reported. The condition was associated with meconium peritonitis due to a perforation proximal to a portion of the transverse colon that was completely surrounded by the tumor. The 12 previously published cases of leiomyosarcoma of the colorectum in childhood are reviewed, and the pathogenesis of meconium peritonitis is discussed.

Topics: Colonic Neoplasms; Female; Humans; Infant, Newborn; Leiomyosarcoma; Meconium; Peritonitis

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

Topics: Acetylcysteine; Adolescent; Autopsy; Child; Child, Preschool; Cystic Fibrosis; Female; Humans; Hydrogen Peroxide; Ileum; Infant; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Intestine, Small; Male; Meconium; Pancreatin; Peritonitis; Prognosis; Radiography, Abdominal; Therapeutic Irrigation; Vitamin K Deficiency

Topics: Humans; Infant, Newborn; Male; Meconium; Peritonitis; Scrotum; Testicular Hydrocele

We report a patient with combination of esophageal atresia, proximal tracheoesophageal fistula and meconium peritonitis. These two rare disorders have different etiology, pathogenetic mechanisms and require different diagnostic manipulations and surgical treatments. The authors discuss the features of diagnosis and surgical treatment of this disease.. Представлен клинический случай сочетания атрезии пищевода с проксимальным трахеопищеводным свищом и мекониевого перитонита. Два редких заболевания, которые имеют разную этиологию и патогенетические механизмы развития, требуют различных диагностических манипуляций и оперативного лечения, описаны у одного ребенка. В статье отражены особенности диагностики и хирургического лечения ребенка.

Topics: Esophageal Atresia; Humans; Infant, Newborn; Meconium; Peritonitis; Rare Diseases; Tracheoesophageal Fistula

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

We reviewed the outcomes of meconium peritonitis and evaluated the safety and feasibility of primary radical surgery for meconium peritonitis. A total of 21 cases of meconium peritonitis between 2006 and 2020 were retrospectively reviewed. The patients were classified into two groups based on the type of surgery: group I (primary radical surgery, n = 16) and group II (multistage surgery; drainage only or ileostomy, followed by elective surgery, n = 5). Patient backgrounds and surgical outcomes were compared between the two groups. The term of prenatal diagnosis, preoperative white blood cell count, and preoperative catecholamine use were not significantly different between the two groups. Group I included more mature neonates than group II (gestational age at birth, 35w1d vs 30w1d, p = 0.02; birth weight, 2.5 kg vs 1.1 kg, p < 0.01). Preoperative C-reactive protein was significantly lower in group I (0.37 mg/dL vs 2.8 mg/dL, p < 0.05). Operation time, blood loss, time to enteral feeding, and complication rates were not significantly different between the two groups. The surgical outcomes of primary radical surgery were comparable to those of multistage surgery, although the patients' backgrounds were different. Our strategy of selecting one-stage or multiple-stage surgery for treatment of meconium peritonitis, depending on the patient's general condition and degree of intestinal ischemia, was reasonable.

Topics: Feasibility Studies; Female; Gestational Age; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Retrospective Studies

To explore the prenatal ultrasonographic characteristics and pregnancy outcomes of fetal meconium peritonitis (FMP).. 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.. 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.. 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

Topics: Female; Fetal Diseases; Fetal Macrosomia; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Pregnancy

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Meconium; Peritonitis

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).. 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.. 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]).. 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

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Tuberculosis, Pulmonary

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.. 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.. 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

Meconium peritonitis (MP) is a rare fetal disease that needs to be urgently identified for surgical intervention. We report a series of 35 patients diagnosed prenatally with MP by magnetic resonance imaging (MRI), illustrate the imaging findings and investigate the predictive value of these findings for postpartum management.. A consecutive cohort of patients diagnosed with MP who were born at our institution from 2013 to 2018 was enrolled retrospectively. The prenatal ultrasound and MRI findings were analyzed. Fisher's exact probability test was used to evaluate the predictive value of MRI for surgical intervention between the operative group and the nonoperative group.. Ascites (30/35) and distended bowel loops (27/35) were two of the most common prenatal MP-related findings on fetal MRI. Of the 35 infants, 26 received surgical intervention. All fetuses with MRI scans showing bowel dilatation (14/26, p = 0.048) and micro-colorectum (13/26, p = 0.013) required surgery. There were no significant differences in the number of fetuses with meconium pseudocysts and peritoneal calcifications between the two groups.. Fetuses with bowel dilatation and micro-colorectum on MRI may need postpartum surgical intervention. Infants with only a small amount of ascites and slight bowel distention were likely to receive conservative treatment.

Topics: Adult; Cohort Studies; Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Magnetic Resonance Imaging; Maternal Age; Meconium; Peritonitis; Predictive Value of Tests; Pregnancy; Prenatal Diagnosis; Retrospective Studies; Ultrasonography, Prenatal; Young Adult

Topics: Adult; Cytomegalovirus Infections; Digestive System Abnormalities; Female; Gestational Age; Humans; Infant, Premature, Diseases; Intestinal Volvulus; Meconium; Peritonitis; Respiratory System Abnormalities; Ultrasonography, Prenatal

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

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.. 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.. 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).. 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

Topics: Ascites; Fatal Outcome; Fetal Diseases; Humans; Ileum; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Respiratory Distress Syndrome, Newborn

To use prenatal magnetic resonance imaging (MRI) to define features of meconium peritonitis (MP) and analyse the relationship between prenatal MRI findings and postnatal outcomes.. Eight cases were enrolled who had been diagnosed with MP through prenatal MRI; the diagnoses were confirmed at surgery and pathology or follow-up. MP was diagnosed by the findings of meconium ascites, meconium pseudocyst, or dilated bowel loops. Prenatal follow-up after diagnosis by MRI was performed by ultrasound.. Prenatal MRI findings included massive meconium ascites (five out of eight cases), a small meconium pseudocyst (one out of eight), a large meconium pseudocyst along with a dilated bowel loop (one out of eight), a dilated bowel loop alone (one out of eight), and micro-colorectum (six out of eight). Six fetuses showed abdominal distension, bilious vomiting, and no normal meconium at birth; they underwent exploratory laparotomies and subsequently, survived and prospered. Only one fetus (with a small meconium pseudocyst) received conservative treatment. There was one mortality, and the cause of death was full-bowel necrosis.. Prenatal MRI may be helpful for diagnosing MP, in cases where the specific MRI findings are persistent meconium ascites, a dilated bowel loop, micro-colorectum, and meconium pseudocyst. In particular, a micro-colorectum might indirectly reflect ileum atresia, which requires postnatal surgery.

Topics: Female; Humans; Infant, Newborn; Magnetic Resonance Imaging; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis

Prenatal ultrasonography (US) in a 39 year-old woman revealed massive fetal ascites. A fetal abdomino-amniotic shunting procedure was performed. Subsequently, plain radiographs demonstrated diffuse gaseous distention of the bowel and multiple punctate calcifications in the left upper abdomen. Postnatal US examination showed multiple echogenic foci in the liver and the left upper abdomen, bowel wall thickening in the right-sided abdomen, and undescended testes. There was no intra-abdominal free air or loculated fluid collections. Medical management was instituted secondary to the clinical suspicion of omental calcification, necrotizing enterocolitis, and undescended testes. Follow-up US examination showed resolution of portal vein gas and bowel wall thickening. The neonate recovered fully.

Topics: Adult; Calcinosis; Cryptorchidism; Enterocolitis, Necrotizing; Female; Fetal Diseases; Fetal Therapies; Humans; Infant, Newborn; Male; Meconium; Omentum; Peritoneal Diseases; Peritonitis; Pregnancy; Ultrasonography, Prenatal

The role of imaging in meconium peritonitis is not limited to establishing a diagnosis; rather, it might also be helpful in determining which neonates require surgery. However, few data in the literature correlate the postnatal radiographic and sonographic findings with the need for surgery.. To compare the role of postnatal radiographic and sonographic findings in predicting the need for surgery in neonates with meconium peritonitis.. We conducted a retrospective analysis of clinical, imaging and surgical findings in all neonates with meconium peritonitis in the period 1999-2014. We divided the children into operative or non-operative groups and then correlated each group with the presence or absence of the following findings on both the radiographs and sonograms: peritoneal calcification, meconium pseudocyst, intestinal obstruction, volvulus, ascites and pneumoperitoneum.. Thirty-seven neonates (22 males, 15 females) had meconium peritonitis in this period, of whom 23 (62%) required surgery and 14 (38%) were successfully treated non-surgically. None had an antenatal infection and three had cystic fibrosis (8%). Bowel obstruction identified on radiography (12/23, P=0.01) and sonography (9/23, P=0.04) and ascites identified with sonography (7/23, P=0.01) were associated with the need for surgical intervention. The presence of pneumoperitoneum and volvulus were also associated with surgical intervention. There was no significant statistical difference in the number of neonates with diffuse peritoneal calcification who were treated operatively or non-operatively. Four (33%) of the 12 neonates with meconium pseudocysts were successfully treated non-operatively.. Imaging findings that predicted the need for surgery were intestinal obstruction, ascites, volvulus and pneumoperitoneum. Neonates with meconium pseudocysts did not require surgery if they were not associated with the described findings. The findings in our patients also indicate that those with diffuse peritoneal calcification as an isolated finding can be successfully treated non-operatively.

Topics: Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Predictive Value of Tests; Retrospective Studies; Treatment Outcome; Ultrasonography

Meconium peritonitis is a sterile chemical peritonitis preceded by bowel perforation, resulting in meconium leakage and subsequent inflammatory cascade within the peritoneal cavity. The presentation can range from simple failure of the neonate to pass meconium to complications such as persistent pulmonary hypertension, lung hypoplasia, and systemic inflammatory syndrome. The purpose of this article is to review a case of meconium peritonitis while considering its etiology, diagnosis, management, and multidisciplinary team care.

Topics: Adult; Education, Nursing, Continuing; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Middle Aged; Neonatal Nursing; Nurses, Neonatal; Peritonitis; Practice Guidelines as Topic; Treatment Outcome

Topics: Fetal Diseases; Fetal Therapies; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Taiwan; Ultrasonography, Doppler; Ultrasonography, Prenatal

Topics: Gastric Bypass; Gastric Outlet Obstruction; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pylorus; Radiography

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.. We conducted a retrospective analysis of a cohort of 18 infants with MP from April 2004 to March 2014.. 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.. 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.

Topics: Ascites; Cohort Studies; Combined Modality Therapy; Digestive System Abnormalities; Female; Follow-Up Studies; Gestational Age; Humans; Incidence; Infant, Newborn; Intestinal Perforation; Intestine, Small; Male; Meconium; Peritonitis; Postoperative Complications; Pregnancy; Prognosis; Retrospective Studies; Singapore; Survival Analysis; Ultrasonography, Prenatal

Topics: Adult; Duodenal Obstruction; Female; Fetal Diseases; Humans; Intestinal Atresia; Meconium; Peritonitis; Pregnancy; Premature Birth; Ultrasonography, Prenatal

There are five reported cases of fetal meconium peritonitis developing after episodes of maternal hepatitis. These cases demonstrate a potential association between severe maternal liver injury and subsequent fetal meconium peritonitis.. A 26-year-old primigravid woman developed acute liver failure 4 days after unilateral oophorectomy for ovarian torsion at 24 weeks of gestation. Her liver function gradually normalized with conservative management. She was readmitted for acute abdominal pain with elevated blood pressure at 29 weeks of gestation. An emergency cesarean delivery was performed for severe preeclampsia. Her neonate was noted to have a distended abdomen. Laparotomy and bowel resection were performed for meconium peritonitis and bowel perforation.. Fetal meconium peritonitis may develop after severe maternal liver disease. Thus, the latter may warrant heightened fetal surveillance.

Topics: Adult; Cesarean Section; Female; Humans; Hypertension, Pregnancy-Induced; Infant, Newborn; Intestinal Perforation; Liver Failure, Acute; Male; Meconium; Obstetric Surgical Procedures; Ovariectomy; Peritonitis; Pre-Eclampsia; Pregnancy

Topics: Adult; Cesarean Section; Cystic Fibrosis; Fatal Outcome; Female; Fetal Diseases; Fetal Heart; Humans; Meconium; Myocardial Infarction; Peritonitis; Pregnancy; Ultrasonography, Prenatal

This is an unusual case in comparison to other sonographically described prenatal cases due to very early diagnosis and surgical intervention following prompt delivery. A 40-year-old pregnant, ultrasonography showed presence of cystic structure in the fetal abdomen that was consistent with intestinal dilatation. At 32 weeks' of gestation, repeat ultrasound showed collapse of the bowel dilatation along with the presence of hyperechogenic fluid in the fetal abdominal cavity. Cesarean section was performed. The clinical utility of this report is the recognition that meconium peritonitis (MP) may be diagnosed in the acute phase with typical ultrasound features, and should be considered in the differential diagnoses of cases presented with reduced fetal movements. Although it appears that morbidity and mortality in MP cases depend upon gestational age, this case report may help to manage similar cases for defining the appropriate delivery time and treatment modality after prenatal identification of the problem.

Topics: Abdomen; Adult; Diagnosis, Differential; Female; Fetal Diseases; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Intestinal Volvulus; Male; Meconium; Peritonitis; Pre-Eclampsia; Pregnancy; Prenatal Diagnosis; Ultrasonography, Prenatal

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

Topics: Abdomen; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Meconium; Peritonitis; Radiography, Abdominal; Treatment Outcome

Topics: Calcinosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Radiography

Autoimmune hepatitis (AIH) in pregnancy can affect both fetal and maternal outcomes. Little is known regarding the fetal outcomes of AIH in pregnancy. The major risks include spontaneous abortions, fetal mortality, perinatal mortality and prematurity. Two common drugs used in the management of AIH, azathioprine and prednisone, may also be associated with adverse fetal outcomes. We present the case of perinatal focal intestinal perforation with a meconium pseudocyst in a preterm infant of a mother with autoimmune hepatitis on azathioprine and methylprednisone.

Topics: Adult; Ampicillin; Anti-Bacterial Agents; Azathioprine; Enterococcus faecalis; Female; Gentamicins; Gram-Positive Bacterial Infections; Hepatitis, Autoimmune; Humans; Ileostomy; Immunosuppressive Agents; Infant, Newborn; Infant, Premature; Intestinal Perforation; Laparotomy; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Outcome; Risk Factors; Treatment Outcome; Ultrasonography

Topics: Adult; Aged; Cesarean Section; Female; Follow-Up Studies; Granuloma; Humans; Meconium; Middle Aged; Peritonitis; Pleural Effusion; Postoperative Complications

Intestinal atresia type III B (apple peel) and gastroschisis are both congenital malformations who require early surgical correction in neonatal age. Their association is very rare. We present the case of a full term infant with partial apple peel ileal atresia and a small defect of the anterior abdominal wall, complicated by in utero intestinal perforation and subsequent meconial peritonitis. We observed a partial atresia of small intestine, with involvement of terminal ileus savings of jejunum and a large part of the proximal ileum, small anterior abdominal wall defect with herniation of few bowel loops, intestinal malrotation. Paralytic ileus and infections are the main causes of morbidity and mortality at neonatal age. In our case, in spite of the mild phenotype, prognosis has been complicated by the onset of functional bowel obstruction, caused by chemical peritonitis resulting from contact with either amniotic fluid and meconium.

Topics: Abdominal Wall; Bacteremia; Fatal Outcome; Female; Hernia, Abdominal; Humans; Ileum; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Uterine Perforation

Prenatal ultrasound (US) diagnosis of fetal intra-abdominal calcification (iAC) is frequently caused by an in utero perforation causing meconium peritonitis. Our ability to predict which fetuses will require postnatal surgery is limited. The aim of our study is to correlate iAC and associated US findings with postnatal outcome.. A single centre retrospective review of all cases of fetal iAC diagnosed between 2004 and 2010 was performed. Maternal demographics, fetal US findings, and outcomes (need for surgery and mortality) were collected. Descriptive and comparative statistical analyses were performed.. Twenty-three cases of iAC were identified. There were no cases of fetal demise or postnatal deaths. Three liveborns (13%) required abdominal surgery at a median of 2 days (0-3) for intestinal atresia. US findings of iAC and dilated bowel with (p=0.008) or without (p=0.005) polyhydramnios predicted a need for postnatal surgery as did the combination of iAC, polyhydramnios, and ascites (p=0.008). Conversely, iAC alone or associated with oligohydramnios, polyhydramnios, ascites, or growth restriction did not predict need for postnatal surgery.. The majority of fetuses with iAC on prenatal US do not require surgery. Associated US findings (bowel dilation) can be used to select fetuses for delivery in neonatal surgical centres.

Topics: Abdomen; Ascites; Calcinosis; Delivery Rooms; Delivery, Obstetric; Dilatation, Pathologic; Early Diagnosis; Female; Fetal Diseases; Fetal Growth Retardation; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Oligohydramnios; Operating Rooms; Patient Selection; Peritonitis; Polyhydramnios; Pregnancy; Retrospective Studies; Treatment Outcome; Ultrasonography, Prenatal

Topics: Abdominal Neoplasms; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intestinal Atresia; Meconium; Peritonitis

Meconium peritonitis is caused by an intestinal perforation that may occur in the fetus, followed by severe chemical peritonitis, resulting in high morbidity.. We have experienced six patients with meconium peritonitis. Cystic drainage was performed soon after birth for all patients. We investigated the concentrations of several cytokines and a chemokine (interleukin 8) in the ascites from the six patients with meconium peritonitis. In two patients we also measured the serum cytokines and chemokine level just after birth.. Interleukin 6 and interleukin 8 concentrations were very high in the cyst or ascites just after birth. In the serum taken from two patients, the levels of interleukin 6 and interleukin 8 were also high. In five patients who underwent drainage of cysts after birth, systemic inflammation could not be completely suppressed before curative surgery.. Interleukin 6 and interleukin 8 play important roles in the inflammatory response syndrome associated with meconium peritonitis, and drainage of cystic fluid did not completely suppress this inflammation. To lessen the high morbidity of meconium peritonitis, efforts should be made to suppress the inflammatory response using new treatment strategies, such as administration of steroids or anti-cytokine therapy to supplement cystic drainage.

Topics: Ascites; C-Reactive Protein; Chemokines; Cyst Fluid; Cytokines; Drainage; Fatal Outcome; Female; Fetal Diseases; Hernia, Diaphragmatic; Humans; Infant, Newborn; Interleukin-6; Interleukin-8; Intestinal Perforation; Male; Meconium; Peritonitis; Prognosis; Syndrome

Twin-to-twin transfusion syndrome (TTTS) is due to unbalanced inter-twin bloodflow through placental vascular anastomoses. We present a TTTS case treated with fetoscopic laser photocoagulation (FLP) that was complicated by perinatal meconium peritonitis in both twins. Ten weeks following laser treatment, the two fetuses showed intra-abdominal hyperechogenicity and ascites. After birth, the two newborns were surgically managed for peritonitis. We discuss the pathogenesis of this double insult. The present case highlights the role of end-circulation bowel thrombi as the potential cause of subsequent intestinal perforation.

Topics: Adult; Cesarean Section; Fatal Outcome; Female; Fetofetal Transfusion; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Pregnancy, Twin; Ultrasonography, Prenatal

We report a case of a meconium pseudocyst secondary to ileal atresia and midgut volvulus. Initially, a single anechoic cyst was detected on prenatal sonography. The cyst gradually increased in size during the second trimester and eventually appeared as a large mass in the lower abdomen with echogenic content and associated with bowel dilatation. This case indicates that until the mid third trimester a single sonolucent cyst without signs of bowel obstruction may be associated with congenital intestinal obstruction.

Topics: Adult; Female; Humans; Ileostomy; Infant, Newborn; Intestinal Atresia; Intestine, Small; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Intra-abdominal calcification is uncommon in newborns and has several causes of which meconium peritonitis is the most frequent. Three neonates with intra-abdominal calcification as a complication of meconium peritonitis are presented. The types of meconium peritonitis were cystic, meconium pseudocyst and meconium ascites. Two required surgical intervention. Meconium peritonitis should be considered in newborns with intra-abdominal calcification.

Topics: Adult; Calcinosis; Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Radiography, Abdominal; Ultrasonography

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.

Topics: Abdomen; Abdominal Neoplasms; Adult; Cysts; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal; Uterine Perforation

Newborn surgery for meconium peritonitis (MP) is sometimes very difficult owing to severe adhesions and bleeding. The aim of this study was to reveal the benefit of primary anastomosis (PA) for MP by comparing PA with multistep operations (MO).. We retrospectively reviewed 38 patients with MP who underwent surgery in our institution from 1983 to 2009. From 1983 to 2000, we essentially used MO. After 2001, we used PA with the exception of 1 patient. We performed MO on 20 patients (group A) and PA on 18 patients (group B).. Mortality was 4 in 20 in group A and 1 in 18 in group B. Three patients in group A and 2 in group B required reoperation because of complications. After 2001, 14 of 16 patients underwent PA. Of the 2 patients for whom PA could not be performed, one was postresuscitation from cardiopulmonary arrest and the other was an extremely low-birth-weight infant. The only mortality among the patients who underwent PA occurred in a very low-birth-weight infant who died from intraoperative hepatic hemorrhage.. PA can be performed for almost all patients with MP except for extremely low-birth-weight infants.

Topics: Anastomosis, Surgical; Contraindications; Cysts; Disease Management; Drainage; Humans; Ileostomy; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Infant, Very Low Birth Weight; Intestinal Atresia; Intestinal Perforation; Intestinal Volvulus; Intussusception; Jejunostomy; Meconium; Peritonitis; Postoperative Complications; Reoperation; Retrospective Studies; Ultrasonography, Prenatal

In this paper, we report the synthesis and pharmacological evaluation of pyrazine N-acylhydrazone (NAH) derivatives (2a-s) designed as novel analgesic and anti-inflammatory drug candidates. This series was planned by molecular simplification of prototype 1 (LASSBio-1018), previously described as a non-selective cyclooxygenase inhibitor. Derivatives 2a-s were evaluated in several animal models of pain and inflammation, standing-out compound 2o (2-N'-[(E)-(3,4,5-trimethoxyphenyl) methylidene]-2-pyrazinecarbohydrazide; LASSBio-1181), that was also active in a murine model of chronic inflammation (i.e., adjuvant-induced arthritis test in rats) and can be considered a new analgesic and anti-inflammatory lead for drug development.

Topics: Analgesics; Animals; Anti-Inflammatory Agents; Arthritis; Ear; Edema; Female; Freund's Adjuvant; Hydrazones; Male; Mice; Pain; Peritonitis; Pyrazines; Rats; Rats, Wistar; Zymosan

Topics: Abdominal Wall; Duodenum; Female; Fetal Diseases; Hernia, Abdominal; Humans; Infant, Newborn; Interdisciplinary Communication; Intestine, Small; Meconium; Obstetric Labor, Premature; Patient Care Team; Peritonitis; Pregnancy; Stillbirth; Ultrasonography, Doppler; Ultrasonography, Prenatal; Young Adult

Meconium peritonitis (MP) may induce prolonged cholestasis after laparotomy. In this study, we investigated the postoperative clinical course of MP retrospectively and discuss the relationship between MP and the development of obstructive jaundice, including biliary atresia (BA).. Between 1979 and 2008, 23 infants with MP underwent laparotomy at our institution. Eleven of the 23 infants (47.8%) developed obstructive jaundice postoperatively. The medical charts of these 11 infants were reviewed.. The causative disease underlying MP included jejunoileal atresia in 10 and cloacal anomaly in 1. Of these 11 infants, 4 had acholic stools. Nine of the 11 improved with conservative management including an expectant approach, choleretic agents, and exchange blood transfusion. To differentiate the diagnosis from BA, open cholangiography was required in 2 cases following negative HIDA scintigraphy and a small gallbladder on ultrasonography. One of these 2 cases was diagnosed as BA and underwent hepatic portoeneterostomy simultaneously, after which the infant became jaundice free.. Postoperative cholestasis after MP was a transient condition in most cases. However, ultrasonography and HIDA scintigraphy should be performed to differentiate BA in infants with MP who show prolonged jaundice with acholic stools.

Topics: Cholangiography; Diagnosis, Differential; Female; Follow-Up Studies; Gestational Age; Humans; Infant; Infant, Newborn; Jaundice, Obstructive; Laparotomy; Male; Meconium; Peritonitis; Portoenterostomy, Hepatic; Retrospective Studies; Treatment Outcome

Topics: Humans; Infant, Newborn; Intestinal Obstruction; Intestinal Volvulus; Intestine, Small; Meconium; Peritonitis; Radiography

We report a case of emergent massive meconium peritonitis due to intrauterine volvulus without malrotation. Fetal ascites was detected on a regular ultrasonographic examination, and fetal distress was found on cardiotocographic monitoring. The mother had noticed a slight decrease in fetal movements over the preceding 24 hours. Prenatal magnetic resonance imaging allowed us to distinguish the meconium from fetal peritoneal fluid and to evaluate the degree of compression of the fetal thoracic cavity. The infant was delivered by emergency cesarean section and demonstrated tense abdominal ascites with edema at birth. She required cardiopulmonary resuscitation and immediate paracentesis.

Topics: Adult; Cardiopulmonary Resuscitation; Cesarean Section; Female; Humans; Infant, Newborn; Meconium; Meconium Aspiration Syndrome; Peritonitis; Treatment Outcome; Ultrasonography, Prenatal

Ochrobactrum anthropi is a non-fermenting gram-negative rod that was identified as a pathogenic microorganism during the past decade. O. anthropi is extensively distributed in the environment, and has been found in hospital and environmental water sources. O. anthropi infection is rare in childhood. We report a case of O. anthropi bacteremia in a preterm infant with a peritoneal lavage catheter and meconium peritonitis.

Topics: Adult; Bacteremia; Catheters, Indwelling; Fatal Outcome; Female; Gram-Negative Bacterial Infections; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intestinal Perforation; Meconium; Ochrobactrum anthropi; Peritoneal Lavage; Peritonitis; Pregnancy

We presented the case of a neonate with portal venous gas and pulmonary gas embolism. The patient presented with severe respiratory distress and abdominal distension 12 hours after birth. An ultrasound revealed intravascular microbubbles moving into a pulmonary artery that were traveling from the portal venous system through a ductus venosus. Additional clinical observations were hypotension and a sudden decrease in end-tidal carbon dioxide with a markedly discrepant high Pco(2), indicating a massive pulmonary gas embolism. Operative findings revealed congenital ileal atresia and meconium peritonitis with abscess. Gas-forming Escherichia coli was recovered from the abscess contents. The patient had respiratory distress, shock, disseminated intravascular coagulation, and intractable diarrhea but eventually recovered and was discharged on the 131st postoperative day.

Topics: Embolism, Air; Female; Humans; Ileum; Infant, Newborn; Intestinal Atresia; Meconium; Peritonitis; Portal Vein; Pulmonary Embolism

Meconium peritonitis is a sterile chemical peritonitis resulting from intestinal perforation in-utero. We present a preterm male neonate weighing 1820 g in whom foetal meconium peritonitis was diagnosed by antenatal utrasonogram. Examination of the newborn in the immediate postnatal period revealed a firm lump of size 5 x 3 cm in the right lumbar and umbilical area. Rest of the abdomen was normal without any clinical evidence of intestinal obstruction. X-ray of abdomen done at 3 hours of life showed a cystic mass with calcified margin. Ultrasonography of abdomen ruled out any definite cause of intestinal obstruction and perforation. He was kept on conservative management. At 11 hours of life the neonate passed a small sticky white mucus plug per rectum followed by black colored meconium of normal consistency 2 hours later. The bowel habit remained regular thereafter. Screening for intrauterine infections and cystic fibrosis was negative. He is under regular follow-up and is now 6 months old with normal bowel habit. A lump of size 2 x 2 cm is still palpable and a small calcified mass is persistent in x-ray. Role of an intestinal mucus plug as the potential factor for intestinal obstruction and subsequent perforation has been highlighted in the present case.

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis; Premature Birth; Treatment Outcome; Ultrasonography

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.

Topics: Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Retrospective Studies; Ultrasonography

Meconium peritonitis (MP) is a rare prenatal condition that leads to substantial neonatal morbidity and mortality.. All patients between 1998 and 2006 referred for prenatal diagnosis were retrospectively analyzed for diagnosis of MP. Prenatal ultrasound findings were compared with postnatal etiology, intraoperative findings, and postnatal outcome of the patients.. Antenatal MP was diagnosed in 14 fetuses between 18 and 38 weeks' gestation. The prenatal diagnosis of MP was confirmed by clinical and radiological findings in 8 (62%) of 13 infants born alive. All patients were delivered preterm between 33 and 36 weeks' gestation by cesarean section. Urgent neonatal surgery for treatment of bowel obstruction was required in all eight infants. Prenatal ultrasound diagnosis of bowel dilatation was the only variable found to be associated with the need for subsequent surgical intervention (P=0.02).. Clinical outcome of MP diagnosed antenatally can be either mild or severe form. The underlying cause of severe MP is heterogeneous and neonatal surgery was always required.

Topics: Dilatation, Pathologic; Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Peritonitis; Pregnancy; Retrospective Studies; Treatment Outcome; Ultrasonography, Prenatal

A rare complication (appendiceal perforation with meconium peritonitis) was observed in a second trimester fetus affected by nonimmune fetal hydrops due to parvovirus B-19 infection. The complication is not considered specific to this or any other etiology for hydrops, which is highly heterogeneous; rather it is an expression of the fragility and friability of edematous tissues.

Topics: Adolescent; Appendicitis; Fatal Outcome; Female; Humans; Hydrops Fetalis; Meconium; Parvoviridae Infections; Parvovirus B19, Human; Peritonitis; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, Second; Ultrasonography, Prenatal

Prenatal ultrasound (US) diagnosis and postnatal outcome are reviewed in three babies with the complex form of meconium peritonitis (MP), the cystic type. Perinatal management is discussed. Large intra-abdominal cysts with signs of calcifications were detected during the second mid-trimester. Meconium ascites and polyhydramnios appeared between 32 and 35 weeks of gestation. Signs of anaemia were assessed on median cerebral artery peak systolic velocity. Sudden appearance of hydrops and anaemia required preterm delivery, neonatal resuscitation and urgent abdominal drainage. Postnatal US imaging confirmed prenatal sonographic evidence. Abdominal X-ray showed calcifications and no free abdominal air. Intestinal diversion was performed in two patients on their first day of life and evolution was uneventful. Hospital death occurred in one baby, who was submitted to delayed surgery due to unstable hemodynamic conditions. Distal ileal perforation walled off by pseudocysts was detected in all cases. One baby was found to be affected by cystic fibrosis. Ileal intussusception was described in the non-surviving infant. The cystic type of MP may have a potentially rapid lethal course and the onset of foetal anaemia and polyhydramnios is a bad prognostic factor. Severe evolution in hydrops and foetal distress may occur at any moment suggesting the persistence of a leakage or re-rupture of the cysts with new meconium spillage into the abdomen. Prenatal detection of ascites, polyhydramnios and pseudocysts requires a strict follow-up, and timing of delivery has to be planned in a tertiary centre. Postnatal radiological imaging does not offer further information over prenatal imaging and surgical decision should not be influenced by the absence of abdominal free air. Urgent abdominal drainage at birth, followed by intestinal diversion of persistent intestinal perforation on the first day of life, may prevent bacterial colonisation and improve prognosis.

Topics: Adolescent; Adult; Cysts; Female; Humans; Infant, Newborn; Meconium; Peritoneal Diseases; Peritonitis; Time Factors; Ultrasonography, Prenatal

Meconium peritonitis (MP) is a chemical peritonitis caused by fetal intestinal perforation in utero. Its incidence is rare, but serious neonatal morbidity or even mortality can occur if the diagnosis is not made until after birth. Prenatal diagnosis is important in prompting early postnatal surgical intervention, and so improving neonatal outcome.. Fourteen cases diagnosed in utero with MP from January 1996 to December 2005 were enrolled in this study. The final diagnoses were established by surgical findings or postnatal radiography. The prenatal ultrasound features, neonatal birth characteristics, surgical findings, postnatal management and neonatal outcomes were reviewed.. All infants received follow-up care at our hospital. Prenatal ultrasound findings included fetal ascites (100%), intra-abdominal calcification (93%), dilated bowel loops (57%), pseudocysts (29%), and polyhydramnios (50%). Four infants (4/14; 28.5%) did not undergo postnatal surgery, but survived well. The mean gestational age at detection was significantly earlier in the non-surgery group (23+/-3.6 weeks) than in the surgery group (31.7+/-2.5 weeks). One infant (7.1%) died because of sepsis after two neonatal operations. The overall survival rate was 92.9%.. MP can be diagnosed by prenatal ultrasound, and the neonatal outcome is favorable. Early detection is not associated with poor neonatal outcome, and selective termination is unnecessary. Resolution of dilated bowel loops and polyhydramnios predict a low rate of postnatal surgical intervention.

Topics: Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Treatment Outcome; Ultrasonography, Prenatal

Meconium peritonitis is a rare disease with a fatal outcome. In Nigeria and Africa, there are only the occasional case reports on the subject matter.. This is a 10-year retrospective study of all patients with meconium peritonitis treated at the University of Maiduguri Teaching Hospital, Maiduguri, Borno State, the Lagos University Teaching Hospital, Lagos State, Obafemi Awolowo University Teaching Hospitals complex, Ile-Ife, Osun State and the Federal Medical Centre Gombe, Gombe State, Nigeria.. There were 10 neonates comprising 6 girls and 4 boys. The median age at presentation was 4 days (range 2-6 days). Six of the mothers of the children with meconium peritonitis had a supervised antenatal care and 4 had antenatal ultrasonography but meconium peritonitis was missed. The most common clinical presentation was abdominal distension at birth in 9 of 10 patients. The abdominal X-rays showed calcification and homogenous opacity in 4 patients and pneumoperitoneum in 2 patients. At laparotomy, all the patients had inflammatory adhesion bands and matted bowel loops. The generalized type was the commonest form observed (7 patients) and giant pseudocyst was noted in 2 patients. The commonest sites of perforation were the ileum in 4 patients and jejunum in 3 patients. In one patient the perforation had sealed at laparotomy. Intestinal obstruction was the commonest cause of meconium peritonitis in 7 of 10 patients. In the remaining 3 patients the cause is unknown. The commonest procedure performed was resection and anastomosis (4 patients). The mortality rate was high (50%).. Our data revealed the rarity of meconium peritonitis and intestinal obstruction as the commonest cause. It is recommended that in patients with an unidentifiable cause a rectal biopsy should be done to rule out Hirschsprung's disease. Early diagnosis, proper operative procedure and meticulous post-operative care should improve their survival.

Topics: Female; Hirschsprung Disease; Humans; Infant, Newborn; Laparotomy; Male; Meconium; Nigeria; Peritonitis; Prenatal Diagnosis; Retrospective Studies; Treatment Outcome

Meconium peritonitis results from antenatal perforation of the gastrointestinal tract; it presents as gastrointestinal obstruction, intraabdominal masses, or calcification. The presentation with passage of meconium per vagina secondary to meconium peritonitis is rare. We describe the radiologic and surgical findings in a neonate who had passage of meconium per vagina secondary to ileal atresia and meconium peritonitis. Initial clinical and radiologic examination suggested rectal atresia with an associated rectovaginal fistula, although subsequently, this was not the case. Possible explanations for the passage of meconium per vagina include decompression of a meconium cyst via the left fallopian tube or direct perforation of a collection into the vagina from the peritoneal cavity.

Topics: Abnormalities, Multiple; Anastomosis, Surgical; Digestive System Abnormalities; Digestive System Surgical Procedures; Female; Follow-Up Studies; Humans; Ileum; Infant, Newborn; Intensive Care Units, Neonatal; Intestinal Perforation; Laparotomy; Meconium; Peritonitis; Pregnancy; Risk Assessment; Treatment Outcome; Ultrasonography, Prenatal; Uterus

Congenital infantile fibrosarcoma is a rare soft tissue malignancy that occurs in both axial and extremity locations. We report a case of this tumor arising from the left colon in a newborn presenting with an intrauterine perforation and meconium peritonitis.

Topics: Colonic Neoplasms; Diagnosis, Differential; Fibrosarcoma; Humans; Infant, Newborn; Laparotomy; Male; Meconium; Peritonitis

This report describes a case of giant cystic meconium peritonitis (GCMP) associated with a cloacal anomaly. Antenatal ultrasonography and magnetic resonance imaging demonstrated persistent fetal ascites, bilateral hydronephrosis, and 3 pelvic cystic structures. The baby girl showed duplicated hydrocolpos and a single orifice of the cloaca with a long common channel inducing a urinary outflow obstruction. After constructing a diversion colostomy, a cutaneous vesicostomy was necessary to prevent recurrent urinary tract infections. These findings are consistent with a prenatal diagnosis of cloacal anomalies, thus suggesting an association with severe obstruction of lower urinary tract and meconium peritonitis. Most of reported cases of meconium peritonitis associated with the cloaca show fibroadhesive types with scattered intraperitoneal calcifications and adhesions. However, the present case showed a rare GCMP suggesting continuous urinary influx via the fallopian tubes until the later stage of intrauterine life.

Topics: Abnormalities, Multiple; Adult; Cesarean Section; Cloaca; Female; Follow-Up Studies; Humans; Hydrocolpos; Laparotomy; Magnetic Resonance Imaging; Meconium; Peritonitis; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, First; Prenatal Diagnosis; Risk Assessment; Treatment Outcome

Fetal meconium peritonitis complicated by bacterial infection is extremely rare. We report a case of fetal ascites at 21 weeks of gestation with subsequent development of loculation, encapsulation, and calcification at 25 weeks. Paracentesis of loculated ascitic fluid at 28 weeks of gestation showed a purulent appearance with the presence of cocci bacteria, increase in white cell count, and a low glucose level, which were suggestive of bacterial infection. However, no sources of maternal infection could be identified. The total bilirubin level of the ascitic fluid was normal (21 micromol/L). A healthy baby was delivered at 37 weeks. CT scan revealed normal bowel without any sign of perforation. We postulate that when ascitic fluid becomes loculated, a normal bilirubin level on paracentesis indicates spontaneous closure of a previous bowel perforation.

Topics: Adult; Ascitic Fluid; Bacterial Infections; Diagnosis, Differential; Female; Fetal Diseases; Gestational Age; Humans; Meconium; Peritonitis; Pregnancy; Tomography, X-Ray Computed; Ultrasonography, Prenatal

Topics: Adult; Contrast Media; Female; Fetal Diseases; Hernia; Herniorrhaphy; Humans; Infant, Newborn; Intestinal Obstruction; Intestine, Small; Meconium; Movement; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Ultrasonography, Prenatal; Young Adult

Cloacal malformations are rare anomalies, occurring in females, and in which they demonstrate a single perineal orifice for urethra, vagina, and rectum. Prenatal ultrasonograms (US) of cloacal malformations sometimes show ascites, hydrocolpos, and hydronephrosis. We herein describe the characteristic prenatal US and magnetic resonance imaging (MRI) findings of the cloacal malformations associated with meconium peritonitis.. The pre- and postnatal records of 11 newborn patients with cloacal malformations, treated in our hospital from 1988 to 2004, were reviewed. All fetuses underwent prenatal US by experienced obstetricians, whereas in addition, fetal MRI was performed in 1 patient.. The prenatal US and/or MRI findings showed fetal ascites, a multicystic pelvic mass, oligohydramnios, and bilateral hydronephrosis in 5 of 11 patients with cloacal malformations. In these 5 cases, postnatal examinations showed associated hydrocolpos, hydrometrocolpos, and bilateral hydronephrosis; furthermore, 4 of these 5 cases also showed meconium peritonitis at laparotomy.. The prenatal US and MRI findings, showing fetal ascites, multicystic pelvic mass, bilateral hydronephrosis, and oligohydraminios are highly suggestive of the cloacal malformations associated with meconium peritonitis.

Topics: Abdomen; Abnormalities, Multiple; Cloaca; Esophageal Atresia; Female; Gestational Age; Humans; Hydrocolpos; Hydronephrosis; Infant, Newborn; Magnetic Resonance Imaging; Meconium; Peritonitis; Prenatal Diagnosis; Ultrasonography, Prenatal; Uterus; Vagina

Meconium peritonitis (MP) is a chemical peritonitis, and little is known about its natural history. Below we report MP in both fetuses from a twin pregnancy, with identical clinical ultrasonographic findings but a delay in presentation.. A 31-year-old woman with a twin pregnancy was referred to our institution due to fetal bowel dilatation and ascites. Serial ultrasonography demonstrated gradual but dynamic changes. Both infants were delivered at 29 weeks'gestation. The larger infant had type II MP and experienced more postoperative complications and longer ventilatory care, parenteral nutrition and hospital stay than the smaller one, who had type III MP.. The type of MP at birth may be more important than birth weight in terms of neonatal morbidity. This case increases our understanding of the natural history and prognosis of MP.

Topics: Adult; Ascites; Calcinosis; Cysts; Dilatation, Pathologic; Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Outcome; Pregnancy, Multiple; Twins; Ultrasonography, Prenatal

The case of a 36 year-old primigravida is presented. After a normal anomaly scan at 22 weeks and a normal pregnancy, she went into labor at term. Dystocia due to massive abdominal distension complicated the second stage. The newborn girl had meconium peritonitis with colonic perforation and required colonic resection with colostomy. Genetic testing detected cystic fibrosis. In this case complex meconium peritonitis developed silently (without any clinical sign) after a normal anomaly scan. This has not been reported since the start of the widespread use of obstetric ultrasound. Late meconium peritonitis can escape detection and should be thought of in cases of unexpected abdominal distension causing dystocia.

Topics: Abdomen; Adult; Colon; Colonic Diseases; Cystic Fibrosis; Dystocia; Female; Fetal Diseases; Homozygote; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy

Intrauterine intussusception with a leading point of Meckel's diverticulum is a rare cause of ileal atresia, which may cause bowel obstruction and perforation. We report such a case complicated by meconium peritonitis. The fetal ultrasonogram revealed ascites, dilated bowel loops and intra-abdominal calcification at a gestational age of 30 weeks. The patient was delivered at 37 weeks and laparotomy was performed to manage the intestinal obstruction. The operative findings showed that Meckel's diverticulum had induced intussusception associated with the ileal atresia with meconium peritonitis. The ileum was resected with end-to-end anastomosis. The postoperative course was uneventful. In this patient, ascites and intraperitoneal calcification were caused by ileal atresia, which may have been induced by intrauterine intussusception.

Topics: Diseases in Twins; Female; Fetal Diseases; Humans; Ileum; Infant, Newborn; Intestinal Atresia; Intussusception; Meckel Diverticulum; Meconium; Peritonitis; Ultrasonography

To study the relationship between prenatal ultrasound features and postnatal course of meconium peritonitis.. We reviewed our cohort of cases of meconium peritonitis (MP) (n = 13/37, 225 pregnancies or 0.3/1000) as well as those published in the English literature with prenatal ultrasonographic findings and postnatal follow-up (n = 56). The total number of cases (n = 69) was divided into 4 grades of progressive severity based on the number of pertinent sonographic findings: grade 0, isolated intra-abdominal calcifications (n = 18); grade 1, intra-abdominal calcifications and ascites (n = 17) or pseudocyst (n = 2) or bowel dilatation (n = 6); grade 2, two associated findings (n = 20); and grade 3, all sonographic features (n = 6). Presence of polyhydramnios was also recorded. Prenatal predictors of need for neonatal surgery and risk of neonatal death were identified using Chi-square and Fisher exact test, with P < 0.05 considered significant.. Neonatal surgical intervention was required in 0% (0/18) of newborns with grade 0 MP; in 52% (13/25) of those with grade 1; in 80% (16/20) with grade 2; and in 100% (6/6) with grade 3 MP (P < 0.001, Chi-square for trend). Moreover, neonatal surgery was more frequent in the presence than absence of polyhydramnios [69% (18/26) vs 37% (16/43); P = 0.007]. Neonatal mortality was 6% (4/69; 3 after surgery and 1 for premature delivery) and it was confined to the subgroup with polyhydramnios (4/26, 15%).. Prenatal sonographic features are related to postnatal outcome. Persistently isolated intra-abdominal calcifications have an excellent outcome. Delivery in a tertiary care center is recommended when calcifications are associated with other sonographic findings.

Topics: Calcinosis; Cohort Studies; Female; Humans; Infant, Newborn; Italy; Meconium; Peritonitis; Predictive Value of Tests; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Severity of Illness Index; Ultrasonography, Prenatal

Meconium peritonitis is a sterile chemical peritonitis resulting from intrauterine bowel perforation. With the development of neonatal care, the prognosis of meconium peritonitis improved much. We report our clinical experience.. The medical records of patients with meconium peritonitis admitted to the Asan Medical Center from June 1989 to July 2006 were retrospectively reviewed.. Of 41 patients (17 males, 24 females), 38 (92.7%) were suspected to suffer from meconium peritonitis prenatally, at a median gestational age of 32 weeks (range, 21-40 weeks). The most common prenatal sonographic finding was fetal ascites followed by dilated bowel. Ten patients were managed conservatively, but 31 patients underwent operations including resection and anastomosis (22), drainage procedure (4), ileostomy (3) and primary repair (2). The operative 31 cases comprised generalized (16), fibroadhesive (10), and cystic types (5). The main causes were intestinal atresia and idiopathic bowel perforation. The mortality rate was 2.4%, and the morbidity rate was 34.1%.. Good survival rate was achieved. But there was rather high morbidity. More gentle and delicate approach should be done to lower the morbidity.

Topics: Female; Fetal Diseases; Follow-Up Studies; Gestational Age; Humans; Infant, Newborn; Intensive Care Units, Neonatal; Intestinal Perforation; Laparotomy; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Retrospective Studies; Risk Assessment; Severity of Illness Index; Survival Rate; Treatment Outcome; Ultrasonography

Topics: Humans; Iatrogenic Disease; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pneumoperitoneum; Rectum

Two preterm infants with non-immune hydrops fetalis associated with meconium peritonitis are reported. The first presented with a cystic abdominal mass and the second had positive parvovirus B19 serology. The association of meconium peritonitis with hydrops fetalis was through different mechanisms in each patient.

Topics: Adult; Calcinosis; Fatal Outcome; Female; Humans; Hydrops Fetalis; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Male; Meconium; Parvoviridae Infections; Parvovirus B19, Human; Peritonitis; Radiography

The transverse colon is an exceptional location of intestinal duplication. Perforated duplications are rarely described in neonates. Meconium peritonitis (MP) can originate from prenatal perforated intestinal duplication. The authors report a case of a baby girl with prenatal diagnosis of MP. Rapid worsening of clinical aspects at birth and the presence of a pneumoperitoneum on systematic abdominal plain radiographs led to urgent surgery on the 1st day of life. Laparotomy showed a perforated necrotizing tubular duplication of the transverse colon. Removal of the duplication followed by limited segmental colonic resection and double colostomy were carried out. Follow-up was uneventful.

Topics: Colon; Colonic Diseases; Female; Humans; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Meconium peritonitis is a sterile chemical peritonitis caused by peritoneal seeding of meconium from an antenatal gastrointestinal perforation. We report a 32-week preterm female neonate who developed meconium peritonitis due to bowel perforation, secondary to a twisted left fallopian tube mass, which was excised and confirmed by histopathology. This association has not been reported earlier. The infant also developed transient central diabetes insipidus, a very rare condition in a preterm neonate.

Topics: Abnormalities, Multiple; Cysts; Diabetes Insipidus; Diagnosis, Differential; Fallopian Tube Diseases; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Radiography; Torsion Abnormality

Prenatal ultrasonography (USS) is a routine screening test for fetal abnormalities. Its accuracy for detecting meconium peritonitis (MP), which may carry high mortality, is important for prenatal counseling. The aim of this study was to assess the accuracy of prenatal USS for diagnosing MP and predicting patient outcomes.. The prenatal and postnatal medical records of all patients referred to our institutions with confirmed MP were reviewed, with emphasis on prenatal USS findings, results of postnatal investigations, operative findings, outcomes, and possible causes of MP.. From January 2000 to November 2004, seven fetuses were confirmed to have MP at birth. Three MP patients (3/7, 43%) were diagnosed prenatally because of USS showing ascites and calcification/dilated or hyperechoic bowel loops. One (1/7, 14.3%) suspected cystic MP was confirmed by prenatal MRI. In the other three cases, USS showed only ascites. All patients had postnatal contrast CT scans. Two patients' CT scans showed persistent intestinal perforation not visible with prenatal USS, and required emergency operations. All patients survived and prospered, and were sweat test negative.. Prenatal USS allows suspected MP babies to be transferred to a tertiary centre for delivery and appropriate management. In this way, the chances of survival of these babies can be excellent if they are not associated with cystic fibrosis (CF). Prenatal MRI can improve the low diagnostic yield of prenatal USS for MP. Postnatal contrast CT scan is required to define persistent intestinal perforation invisible with prenatal USS.

Topics: Female; Fetal Diseases; Gestational Age; Humans; Intestines; Male; Meconium; Peritonitis; Pregnancy; Radiography; Retrospective Studies; Ultrasonography, Prenatal

An isolated fetal ascites is a rare ultrasonographic finding. It is commonly diagnosed in association with fetal genitourinary or gastrointestinal conditions, mainly bowel obstruction. We present the sonographic features and neonatal outcome of a fetus with a large bowel obstruction, perforation and subsequent development of meconium peritonitis, prenatally diagnosed as isolated fetal ascites. A colonic atresia should be also included in the differential diagnosis of isolated fetal ascites.

Topics: Adult; Ascites; Colectomy; Colon; Colostomy; Female; Humans; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Adult; Diagnosis, Differential; Down Syndrome; Embryonic and Fetal Development; Female; Follow-Up Studies; Gestational Age; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Pregnancy Outcome; Risk Assessment; Severity of Illness Index; Ultrasonography, Prenatal

Topics: Anastomosis, Surgical; Calcinosis; Diagnosis, Differential; Female; Fetal Diseases; Humans; Ileal Diseases; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis; Radiography; Ultrasonography

Topics: Calcinosis; Humans; Infant; Male; Meconium; Peritonitis; Testis; Ultrasonography

Topics: Adolescent; Diagnosis, Differential; Female; Fetal Diseases; Gravidity; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Adult; Ascites; Diagnosis, Differential; Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Ultrasonography, Prenatal

Topics: Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Calcinosis; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Testicular Diseases; Ultrasonography

We report an unusual case of perforation of a congenital fibrosarcoma of the jejunum in utero and secondary meconium peritonitis. Prenatal ultrasound showed polyhydramnios and fetal ascites from 25 gestational weeks in the absence of other fetal congenital anomalies. A 2200 g baby girl was born at 34 weeks gestation, presenting with severe generalized edema and respiratory distress immediately after birth. Plain radiography revealed progressive abdominal distension and pneumoperitoneum. The baby subsequently underwent surgery at the age of one day. A perforation of the upper jejunum, which had resulted in meconium peritonitis, was discovered intraoperatively and the perforated section of the intestine was resected and anastomosed successfully. The postoperative course was uneventful. Pathological examination confirmed that the perforation was caused by rupture of a congenital fibrosarcoma originating from the jejunum. Rupture of a malignant tumor is an extremely rare cause of peritonitis in the fetus and neonate.

Topics: Female; Fetal Diseases; Fibrosarcoma; Humans; Jejunal Neoplasms; Meconium; Peritonitis; Rupture, Spontaneous

Prenatal ultrasound scans reveal variable features of fetal meconium peritonitis. For better understanding of the natural history and postnatal prognosis of meconium peritonitis, we clarified the significance of ultrasound findings in the outcomes of fetuses with meconium peritonitis.. Between 1991 and 2001, fetuses who underwent evaluation for meconium peritonitis were retrospectively analyzed. The diagnosis was made by intra-abdominal calcifications, meconium pseudocyst, or meconium ascites, which were postnatally confirmed by the operative findings and/or abdominal plain films. According to the final ultrasound findings before labor, patients were classified into 3 groups: type I, large meconium ascites; type II, a large pseudocyst; type III, intra-abdominal calcifications, small meconium ascites and/or a shrinking pseudocyst.. Nineteen fetuses (6 boys and 13 girls) were collected. Mean gestational age at diagnosis was 29.1 +/- 5.3 weeks and mean follow-up before delivery was 7.5 +/- 6.2 weeks. Mean gestational age at birth was 36.8 +/- 6.2 weeks. Six fetuses (31.5%) were delivered before 37 weeks of gestation. Type I was found in 5 (26.3%), type II in 3 (15.8%), and type III in 11 (57.9%). Intra-abdominal calcifications were identified in 15 cases (78.9%), polyhydramnios in 4 (21.1%), and oligohydramnios in 3 (15.8%). Cardiopulmonary resuscitation at birth was required in 2 cases (type I). Twelve cases (63.2 %) were spontaneous perforations. Of 7 other cases (36.8%) studied, 6 had intestinal atresia and 1 had associated defects resulting in bowel perforation. Postnatal follow-up revealed all but 2 (died of sepsis and prematurity, respectively) doing well.. Our results indicate that detailed fetal ultrasound scans are crucial for providing a prenatal diagnosis and proper perinatal management of meconium peritonitis. From the viewpoints of our study, proper prenatal counseling and risk evaluation should be offered to the parents of the fetuses with meconium peritonitis.

Topics: Adult; Female; Fetal Diseases; Humans; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Duodenal Obstruction; Esophageal Atresia; Humans; Infant, Newborn; Intestinal Atresia; Male; Meconium; Peritonitis

Exposure of the peritoneal cavity to meconium causes a marked inflammatory response. The effect of intraperitoneal meconium on intestinal morphology and plasma nitrite and nitrate (NO2(-) + NO3(-)) levels and how this inflammatory process is influenced by hyperbaric oxygen (HBO) treatment were investigated in this study. The purpose was to determine whether HBO treatment could be considered a useful adjunct in the resuscitative treatment of severely ill patients admitted with meconium peritonitis (MP). Rats were divided into three groups. Human meconium (MP group, n=10) and sterile saline (control group, n=10) were injected intraperitoneally for 3 days. The procedure for meconium injection was combined with HBO treatment for the HBO group (n=10). HBO was administered for 7 days. In all groups, peritoneal swap cultures, plasma NO2(-) + NO3(-) levels, intestinal diameters, and macroscopic and microscopic changes in the intestine were determined on the 8th day. Bacterial growth was not detected in the peritoneal swap cultures. There was a significant difference in NO2(-) + NO3(-) levels between the MP and HBO groups ( P<0.05), between the MP and control groups ( P<0.01), and between the HBO and control groups ( P<0.05). Thin fibrinous adhesions in both the MP and HBO groups, and thickened and dilated intestinal loops in the MP group were observed macroscopically. The intestinal diameter in the MP group was significantly greater than in the HBO and control groups. The only microscopic difference was seen in the serosal layer. Compared with the animals in the control and HBO groups, the intestine of the rats in the MP group showed prominent serosal thickening, edema, capillary proliferation and cellular infiltration. The ameliorated inflammatory changes and decreased dilatation of the intestine accompanied by a significant decrease in NO2(-) + NO3(-) levels suggest that as an adjunctive treatment, HBO may have a beneficial effect in the resuscitative treatment of meconium peritonitis.

Topics: Animals; Hyperbaric Oxygenation; Inflammation; Male; Meconium; Models, Animal; Peritonitis; Rats

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.

Topics: Adult; Female; Fetal Diseases; Humans; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

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).. 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.. 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.. 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.

Topics: Adult; Cysts; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Retrospective Studies; Treatment Outcome; Ultrasonography, Prenatal

The usual manifestations of meconium peritonitis confined to the inguinoscrotal region are soft hydroceles, hard nodules in the scrotum, and, occasionally, calcified nodules in the wall of a hernia sac, with or without calcification on abdominal X-ray. Inguinal hernia is an extremely rare manifestation of healed meconium peritonitis. An unusual presentation of meconium peritonitis encountered during hernia repair is described herein to alert the pediatric surgeon of this possibility to avoid unnecessary abdominal exploration.

Topics: Hernia, Inguinal; Humans; Infant; Male; Meconium; Peritonitis

We present two cases of fetal meconium peritonitis in a single and twin pregnancy, respectively. The first case diagnosis was made at 30 weeks and was confirmed after delivery of the twins by cesarean section at 37 weeks. The second case diagnosis was made at 31 week and was confirmed at 37 weeks. Meconium peritonitis is a rare prenatal complication that results from intrauterine perforation of small bowel with spillage of sterile meconium into peritoneal cavity. We now report two cases of meconium peritonitis diagnosed at 30 and 31 weeks gestation.

Topics: Adult; Diagnosis, Differential; Female; Fertilization in Vitro; Fetal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Jejunal Diseases; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Pregnancy, Multiple; Twins; Ultrasonography, Prenatal

Simultaneous fulminant maternal hepatitis B infection and fetal meconium peritonitis has never been reported before in the English-language literature.. Fetal meconium peritonitis was detected at 32 weeks' gestation in a 21-year-old woman suffering from fulminant hepatitis. Fulminant hepatitis B was confirmed by clinical observation and serologic examination results. The course was also complicated with preterm labor. The fetus was diagnosed with meconium peritonitis prenatally. Because of failed tocolytic treatment, the fetus was delivered vaginally. Both the mother and fetus received intensive care, and the mother recovered. In contrast, the fetus's course worsened due to progressive abdominal distension. Although exploratory laparotomy was attempted, the operation was not successful. The infant died five days after birth.. Recognition of the predisposing factors in fetal meconium peritonitis and immediate referral to a tertiary medical center, where specialists are available, could help physicians determine an accurate diagnosis and might improve prognosis.

Topics: Adult; Diagnosis, Differential; Fatal Outcome; Female; Fetal Diseases; Hepatitis B; Humans; Infant, Newborn; Liver Failure; Meconium; Obstetric Labor, Premature; Peritonitis; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, Third; Radiography; Ultrasonography, Prenatal

Meconium peritonitis most often is associated with congenital intestinal obstruction and meconium ileus. Uncommonly, other etiologies are identified. Hyperimmunoglobulin E syndrome (Job's syndrome) is a rare genetic disorder that is characterized by recurrent staphylococcal respiratory and skin infections in addition to elevated serum IgE levels. There have been 2 previously reported cases of intestinal complications associated with Job's syndrome. The current case is the third such case and is the first report of meconium peritonitis in a patient with hyperimmunoglobulin E syndrome. The patient presented with a meconium thorax as a result of a concurrent congenital diaphragmatic hernia.

Topics: Cecum; Colonic Diseases; Female; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Muscle, Smooth; Peritonitis; Pregnancy; Thoracic Diseases

A case of congenital immature gastric teratoma along with spontaneous gastric perforation in a 1-day-old boy is presented. The clinical features are similar to those of meconium peritonitis. Coincidentally, the child had an arachnoid cyst at 25 months of age. To the best of the authors knowledge, this case of congenital immature gastric teratoma associated with gastric perforation mimicking meconium peritonitis, is the first description in the English-language literature.

Topics: Diagnosis, Differential; Humans; Infant; Male; Meconium; Peritonitis; Rupture, Spontaneous; Stomach Neoplasms; Teratoma; Ultrasonography, Prenatal

Topics: Hernia; Herniorrhaphy; Humans; Infant; Infant, Newborn; Male; Meconium; Peritonitis

Two cases of meconium periorchitis respectively in a ten-day- and a five-month-old infant are reported. The presenting symptom was a scrotal mass, isolated in one case and associated with pain and inflammation in the other case. Intraoperative histological diagnosis allowed conservative surgery in one case.. About 40 cases of scrotal manifestations of an intrauterine perforation of the gastrointestinal tract are reported in the literature. In cases with associated intraperitoneal calcifications, the diagnosis is easy and surgical exploration may be avoided, spontaneous resolution being the rule. However, in half of the cases, a scrotal mass is the only manifestation and raises the question of a testicular tumor.. Unfamiliarity with this unusual entity may lead to unnecessary orchiectomy.

Topics: Diagnosis, Differential; Humans; Infant; Infant, Newborn; Male; Meconium; Orchiectomy; Orchitis; Peritonitis; Remission, Spontaneous; Testicular Neoplasms

Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Pregnancy Outcome; Prenatal Diagnosis; Sperm Injections, Intracytoplasmic; Twins; Ultrasonography

This report describes our experiences with 5 cases of biliary atresia associated with meconium peritonitis caused by perforation of small bowel atresia.. A review of medical records was undertaken in an effort to recognize cases of biliary atresia associated with meconium peritonitis.. Five patients of 171 with biliary atresia (2.9%) were detected to have meconium peritonitis caused by perforation of small bowel atresia. The biliary atresia was not suspected during the initial operation for meconium peritonitis. Total parenteral nutrition (TPN) made it difficult to make an early differential diagnosis of biliary atresia because of the presence of TPN-associated cholestatic jaundice, and the Roux-en-Y limb used for hepatic portoenterostomy could not be made long enough to prevent cholangitis caused by preexisting short bowel. The main complications were severe, intractable cholangitis, short bowel syndrome with malnutrition; TPN-associated liver injury; and wound problems. Two patients died of ascending cholangitis, 1 patient of liver failure that was exacerbated by TPN-associated liver injury, and 1 patient is awaiting a liver transplant. Only 1 patient is in good health, being anicteric and showing normal growth and development.. Biliary atresia is evidently closely associated with meconium peritonitis caused by perforation of small bowel atresia. The management of these patients is more difficult than that of patients with the usual form of biliary atresia, because of the necessity for a long period of TPN and the combined short bowel syndrome. The ideal management of these conditions has yet to be determined.

Topics: Biliary Atresia; Female; Humans; Infant; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Intestine, Small; Male; Meconium; Peritonitis; Prognosis; Retrospective Studies; Risk Assessment; Severity of Illness Index; Survival Rate

We report a case of in utero paracentesis of ascites in a fetus with meconium peritonitis due to volvulus at 34 weeks which resulted in the correction of an abnormal fetal heart rate pattern and enabled vaginal delivery by preventing abdominal dystocia. The intrauterine intervention also helped to establish the diagnosis and potentially reduced the respiratory compromise after birth.

Topics: Adult; Arrhythmias, Cardiac; Diagnosis, Differential; Female; Fetal Diseases; Fetal Monitoring; Heart Rate, Fetal; Humans; Ileal Diseases; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Paracentesis; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Prenatal Diagnosis; Twins

Topics: Adult; Female; Fetal Diseases; Hepatitis B; Humans; Meconium; Peritonitis; Pregnancy; Pregnancy Complications, Infectious; Ultrasonography, Prenatal

A neonate with ileal atresia (IA) complicated by meconium peritonitis (MP) whose prenatal ultrasonography (US) detected an intrauterine intussusception (IUI) is reported. Fetal ascites, dilated bowel loops, and abdominal calcifications were identified on serial US from 25 weeks of gestation. Intestinal loops with high echogenecity and a "target-like" appearance suggestive of IUI were detected in the right lower quadrant. The 2,680-g male was delivered vaginally at term and underwent a laparotomy. Fibrous adhesions and small calcifications were scattered throughout the peritoneal cavity. IA (interrupted type) was confirmed 17.0 cm cranial to the ileocecal valve (ICV). An ileo-ileal intussusception was also found between 16.5 cm and 9.0 cm cranial to the ICV. Partial resection of the ileum and an ileo-ileal anastomosis was performed. The postoperative course was uneventful. In this case, the pathological process of IUI resulting in IA and MP was demonstrated sonographically by identifying the "target-like" appearance in the fetus.

Topics: Adult; Female; Fetal Diseases; Gestational Age; Humans; Ileum; Infant, Newborn; Intestinal Atresia; Intussusception; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Angiography; Catheterization; Equipment Design; Female; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Intubation, Intratracheal; Meconium; Peritonitis; Surface Properties

Fetus-in-fetu (FIF), a rare congenital anomaly, is a fetus incorporating the well-differentiated tissue of its twin. The authors describe a newborn who presented with massive abdominal distension and severe respiratory distress. Abdominal x-rays showed multiple calcifications. The diagnosis of meconium pseudocyst was made. At emergency laparotomy an irregular fetiform mass was found in the retroperitoneum lying within a fluid-filled amniotic sac. It contained a vertebral column, 10 limblike structures, and cranial and caudal ends, supporting the diagnosis of fetus-in-fetu. This case highlights several important points. FIF often is overlooked in the differential diagnosis of a newborn abdominal mass and, as in this case, may be confused with meconuim pseudocyst. FIF should be differentiated from a teratoma because of the latter's malignant potential. Because this diagnosis is not made until pathological analysis, all parts of the mass should be removed to prevent malignant recurrence.

Topics: Abdomen; Adult; Calcinosis; Diagnosis, Differential; Female; Fetus; Follow-Up Studies; Humans; Infant, Newborn; Laparotomy; Meconium; Mesenteric Cyst; Peritonitis; Pregnancy; Radiography, Abdominal; Teratoma; Treatment Outcome; Twins, Monozygotic

Meconium peritonitis occurring in pregnancies following artificial reproductive techniques (ART) is rare. We report the first case of meconium peritonitis following intracytoplasmic sperm injection (ICSI).. A 37-year-old woman attended our in vitro fertilization (IVF) program because her husband suffered from hypospermatogenetic azoospermia due to cancer surgery and radiotherapy. The patient achieved a twin pregnancy through ICSI from testicular sperm extraction at our IVF center. Meconium peritonitis, fetal ascites, polyhydramnios, bowel dilatation, hydrocele and intraabdominal calcification were noted in one of the twins on ultrasound at 30 weeks' gestation. Cesarean section due to breech presentation in labor was performed at 36 weeks' gestation. A normal female and male infant with a distended abdomen were delivered. Emergency laparotomy was performed on the male twin because of dyspnea. A 0.2-cm perforation was found in the terminal ileum. Ileotomy was performed and closed after 27 days.. Prenatal diagnosis of meconium peritonitis is possible through careful ultrasonographic examination, and early surgical intervention and intensive postoperative support are required to improve the prognosis.

Topics: Adult; Breech Presentation; Cesarean Section; Diseases in Twins; Female; Humans; Ileum; Infant, Newborn; Intestinal Perforation; Male; Meconium; Oligospermia; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Prognosis; Sperm Injections, Intracytoplasmic; Ultrasonography, Prenatal

A 26-year-old, gravida 3 presented at 31 weeks of gestation with polyhydramnios. On ultrasound there was marked foetal ascitis with unilateral hydrocele. Patient delivered a 3.15 kg, large-for-date baby at 33 weeks and 3 days of gestation. On basis of clinical, radiological and sonographic features, diagnosis of meconium peritonitis was made. Ascitic tapping was done. Surgery was withheld, as there were no signs of intestinal obstruction. DNA testing for cystic fibrosis was negative. Baby did not deteriorate so he was discharged. Baby was doing well on 2 months follow up. Hydrocele and ascitis were resolving. Rarely meconium peritonitis may occur without an underlying cause when peritonitis may be innocuous and intervention may not be required.

Topics: Adult; Ascites; Birth Weight; Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Ultrasonography, Prenatal

Although meconium peritonitis is a rare condition, the mortality rate can be as high as 40%. Meconium peritonitis is a result of intestinal perforation in utero, which leads to dense inflammation in the peritoneal cavity. The fetus has relatively immature peritoneal defense mechanisms, so the cause of this dense inflammation is unclear. The peritoneal macrophage is a key cell in the peritoneal inflammatory response in adults. The purpose of this investigation was to determine if sterile meconium had a direct stimulatory effect on the peritoneal macrophage.. Peritoneal macrophages were harvested from adult C3H/HEN mice. The cells were placed in microtiter wells at 10(5) cells per well. Sterile human meconium was diluted in media and placed in the wells at varying concentrations for 8 hours. Lipopolysaccharide (LPS) (10 microg/mL) served as a positive control. Supernatants were harvested and assayed for tumor necrosis factor alpha (TNF-alpha) using a commercial ELISA kit. Separate cells were assayed for TNF-alpha message using polymerase chain reaction (PCR). In another series of experiments, procoagulant activity (PCA) was determined on freeze-thawed cells using a two-stage amidolytic assay. To test for the role of protein kinase C (PKC) in the PCA response H7, a PKC inhibitor, was used as well.. Meconium stimulation resulted in a significant increase in TNF-alpha compared with negative controls with a peak at 0.1% meconium (121 pg/mL v 11 pg/mL, P<.05). There was a significant increase in PCA, with a 10-fold increase with 1% meconium compared with controls (P<.05). This response was limited to less than 5% by PKC inhibition.. Sterile meconium results in a marked proinflammatory response in the peritoneal macrophage with elevations of both PCA and TNF-alpha. The TNF response is likely mediated at a pretranscriptional level because there is a marked increase in TNF mRNA. These data suggest that the PCA response is regulated by a PKC mechanism similar to LPS. Stimulation of the peritoneal macrophage by meconium is a possible cause of the marked inflammation seen in meconium peritonitis.

Topics: Animals; Cells, Cultured; Humans; Macrophages, Peritoneal; Meconium; Mice; Mice, Inbred C3H; Peritonitis; Tumor Necrosis Factor-alpha

Hepatitis A virus has rarely been implicated in congenital infections. After maternal hepatitis A at 13 weeks' gestation, ultrasonographic examinations revealed fetal ascites (20 weeks) and meconium peritonitis (33 weeks). After delivery, a perforated distal ileum was resected. Elevated levels of hepatitis A immunoglobulin G persisted in the infant 6 months after delivery.

Topics: Adult; Ascites; Diagnosis, Differential; Female; Fetal Diseases; Hepatitis A; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Pregnancy Complications, Infectious; Ultrasonography

A 3-day-old premature infant with meconium peritonitis, periventricular leukomalacia, and pulmonary hypertension died with respiratory insufficiency. An autopsy disclosed intravascular squamous cells in the lungs, brain, liver, pancreas, and kidneys. Numerous pulmonary capillaries and arterioles were occluded by squamous cells, accounting for pulmonary hypertension. Brain parenchyma surrounding occluded cerebral vessels showed infarct and gliosis. A mediastinal lymph node filled with squamous cells alluded to the mechanism by which these cells from the peritoneal cavity likely entered the bloodstream--namely, via diaphragmatic pores connecting with lymphatics. Thus, disseminated intravascular meconium rarely may complicate meconium peritonitis and have devastating consequences.

Topics: Embolism; Fatal Outcome; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Premature, Diseases; Meconium; Peritonitis; Pregnancy; Pregnancy Complications; Vascular Diseases

A case of twin-to-twin transfusion syndrome with intrauterine death of one twin and meconium peritonitis and intravascular disseminated coagulation in the other twin is reported. Meconium peritonitis follows to bowel perforation, caused by segmental severe hypoplasia of muscular layer. The Authors suggest that this structural alteration of bowel wall could be an expression of inequal distribution of some cells between the two twins, during embrional development.

Topics: Adult; Colon; Colonic Diseases; Diseases in Twins; Disseminated Intravascular Coagulation; Fatal Outcome; Female; Fetal Death; Fetal Diseases; Fetofetal Transfusion; Hemoperitoneum; Humans; Ileal Diseases; Ileum; Immunoenzyme Techniques; Infant, Newborn; Intestinal Perforation; Meconium; Muscle, Smooth; Peritonitis; Polyhydramnios; Postoperative Complications; Pregnancy; Twins, Monozygotic

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.

Topics: Abdomen; Calcinosis; Disease Progression; Genital Diseases, Male; Hernia, Diaphragmatic; Humans; Infant; Male; Meconium; Peritonitis; Radiography; Scrotum

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

We report sibs (a brother and a sister) who presented prenatally with ultrasound findings of meconium peritonitis and postnatally were found to have perforation of the terminal ileum. The sister presented with fetal ultrasound findings of severe ascites and peritoneal calcifications. She had no prenatal intervention and was born at 38 weeks' gestation. Laparatomy revealed perforation of the terminal ileum with meconium peritonitis. Her post-surgical course was uncomplicated and at 30 months of age her growth and development are normal. Her brother presented prenatally with signs of meconium peritonitis including severe ascites and peritoneal calcifications. Prenatal aspiration of the ascitic fluid was performed and unlike his sister he was born prematurely, was operated on at 8 days, and developed bronchopulmonary dysplasia. He is currently 1 year old and has normal growth and development. The aetiology of the ileal perforation is not known. There were no findings suggesting connective tissue disorder and the aetiology of the intestinal perforation is not known. The occurrence of the same rare abnormality in sibs of different sexes points towards an autosomal recessive disorder.

Topics: Adult; Ascites; Calcinosis; Female; Humans; Intestinal Perforation; Male; Meconium; Peritoneal Diseases; Peritonitis; Pregnancy; Ultrasonography, Prenatal

B19 fetal infection has been associated with hydrops or fetal death. We report four cases of meconium peritonitis in hydropic fetuses with laboratory diagnosis of B19 infection. Parvovirus B19 DNA was detected by in situ hybridization both in cord blood and in amniotic cells in three fetuses, while in one case only cord blood was available and proved positive. Signs of active or recent B19 infection in maternal serum samples were documented only in two cases, which proved positive for specific IgM antibodies anti-B19. Maternal B19 infections were asymptomatic and fetal anomalies were observed during a routine ultrasound scan. A common feature of the hydropic fetuses was the presence of abdominal ascites concomitant with or preceding alterations, suggesting meconium peritonitis. The four pregnancies had a preterm outcome: in two cases infants recovered following surgical treatment, in one case spontaneously, and the other one was stillborn. Since vascular inflammation has been documented in B19 infection and congenital bowel obstruction results from vascular damage during fetal life, our observation suggests the need for investigating B19 infection in the presence of meconium peritonitis for a better understanding of the pathogenetic potential of B19 parvovirus in intra-uterine infection.

Topics: Adult; Antibodies, Viral; DNA, Viral; Fatal Outcome; Female; Fetal Diseases; Humans; Hydrops Fetalis; Infectious Disease Transmission, Vertical; Male; Meconium; Parvoviridae Infections; Parvovirus B19, Human; Peritonitis; Pregnancy; Pregnancy Complications, Infectious; Ultrasonography, Prenatal; Uterine Diseases

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.

Topics: Ascites; Fatal Outcome; Female; Humans; Infant, Newborn; Infarction; Meconium; Peritonitis

Topics: Abdomen; Calcinosis; Female; Foreign Bodies; Hernia, Inguinal; Humans; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis; Physical Examination; Treatment Outcome; Ultrasonography; Ureter; Vulva

Fifteen cases of meconium ileus (MI) were treated between 1986 and 1995; 7 responded to conservative treatment. Eight were operated upon, and comprise the study group. Six of the operated babies had no complications; 1 had meconium peritonitis with a pseudocyst and small-bowel atresia, and 1 had a volvulus of a small-bowel segment with necrosis. In all 8 cases a T-tube (TT) was left via an enterotomy; in the complicated cases the enterotomy was pre-anastomotic. The obstruction was relieved in all the babies, without any stoma or bowel resection in the uncomplicated cases. Two complications occurred: 1 patient died of respiratory failure 1 month following surgery and another required a relaparotomy for lysis of adhesions. We conclude that TT ileostomy is an effective and safe procedure for uncomplicated cases of MI that do not respond to conservative therapy, as well as for complicated cases that need an anastomosis.

Topics: Cause of Death; Female; Follow-Up Studies; Humans; Ileostomy; Infant, Newborn; Intestinal Atresia; Intestinal Obstruction; Male; Meconium; Peritonitis; Postoperative Complications; Survival Rate

Meconium peritonitis is an uncommon chemical peritonitis of a fetus resulting from antenatal bowel perforation. We reported a case of meconium peritonitis with pseudocystic formation diagnosed by color Doppler energy (CDE) at 34 gestational weeks. An echogenic substance inside a fetal abdominal mass was detected using ultrasound. By conventional color Doppler, there was minimal blood flow in the cystic wall or septums of the mass. Using CDE, bowel hyperperistalsis was observed in multiple small bowel loops and the region of intestinal loops into the mass was easily detected. Therefore, the angle independent nature of CDE will play a significant role in the early and accurate diagnosis of meconium peritonitis before birth.

Topics: Adult; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Meconium; Peritonitis; Pregnancy; Ultrasonography, Doppler, Color; Ultrasonography, Prenatal

Topics: Abdomen; Adult; Cysts; Female; Fetal Diseases; Humans; Ileal Diseases; Intestinal Obstruction; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Presentation of one case of meconial hydrocele, a very infrequent disease that should be taken into account in all newborns presenting intrascrotal mass. Ultrasonography performed to a 29 year-old female during the 36th week of pregnancy, demonstrated in the fetus the presence of an enlarged right hemiscrotum with homogenous material inside, which was diagnosed as an intrascrotal haematoma due to a likely intrauterine spermatic cord torsion. After eutocic delivery, within one month from birth the newborn developed signs and symptoms which were compatible with acute scrotum and the emergency surgical exploration showed meconial hydrocele secondary to patency of peritoneal-vaginal duct with associated inguinal hernia. The causes, forms of presentation, differential diagnoses and therapeutical options of meconial peritonitis, a rare condition with favourable evolution in most cases, are analyzed showing that, under certain circumstances, treatment is controversial.

Topics: Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Testicular Hydrocele; Ultrasonography, Prenatal

Topics: Adult; Biomarkers; C-Reactive Protein; CA-125 Antigen; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

An unusual case of meconium peritonitis is reported. A neonate presented with a huge multiseptate effusion in the peritoneal cavity in relation with a small bowel perforation. No calcification was visible. Such a presentation cannot be included in one of the classical types of meconium peritonitis. It could be due to a bowel perforation occurring immediately before birth and could therefore be related to a mixed fibroadhesive and generalized form.

Topics: Diagnosis, Differential; Female; Humans; Infant, Newborn; Intestinal Perforation; Intestine, Small; Magnetic Resonance Imaging; Meconium; Peritoneal Neoplasms; Peritonitis; Ultrasonography

Topics: Calcinosis; Fetal Diseases; Humans; Infant; Male; Meconium; Peritonitis; Radiography, Abdominal; Scrotum

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.

Topics: Ascites; Calcinosis; Cysts; Dilatation, Pathologic; Female; Fetal Diseases; Follow-Up Studies; Gases; Gestational Age; Humans; Ileal Diseases; Ileum; Infant; Infant, Newborn; Intestinal Atresia; Intestinal Diseases; Intestinal Perforation; Intestines; Male; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Pregnancy Outcome; Radiography; Ultrasonography, Prenatal

In nine patients with meconium peritonitis prenatal ultrasonographic findings were correlated with the clinical course and outcome. Ultrasound findings included polyhydramnion (n = 4), ascites (n = 4), disseminated (n = 3) and solitary echogenic areas (n = 1), echopoor cystic areas (n = 3) and echogenic-echopoor solitary areas (n = 1). Intra-abdominal calcifications were found in five patients before delivery. Eight neonates survived and were subsequently followed up, one fetus died in utero. Four of the eight survivors required surgery, namely for meconium ileus (n = 1), perforation secondary to intestinal volvulus (n = 2) and inguinal hernia associated with prenatal rubella infection (n = 1). Three patients were healthy, one patient required drainage of pleural effusion and respirator therapy but recovered without further problems. Cystic fibrosis was diagnosed in the patient with meconium ileus. Postnatal outcome could not be predicted from the prenatal sonographic findings.

Topics: Adult; Calcinosis; Cesarean Section; Cystic Fibrosis; Female; Follow-Up Studies; Gestational Age; Humans; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Ultrasonography, Prenatal

Meconium peritonitis is an uncommon condition almost invariably associated with structural ileal obstruction or meconium ileus. Rarely meconium peritonitis may occur in an isolated form when the clinical course may be benign. We report a case where evidence of meconium peritonitis was only discovered during orchidopexy.

Topics: Child, Preschool; Cryptorchidism; Humans; Infant, Newborn; Male; Meconium; Peritonitis

A patient with acute hydramnios and advanced preterm labor at 34 weeks was seen after gastroschisis had been diagnosed by second-trimester fetal ultrasonography. The fetus also had meconium peritonitis and acute ascites. The distended abdomen did not decompress spontaneously during the second stage of labor. Severe abdominal dystocia was resolved with the Zavanelli maneuver (cephalic replacement) and cesarean delivery. This is the first reported use of the Zavanelli maneuver for abdominal dystocia.

Topics: Abdominal Muscles; Adolescent; Ascites; Cesarean Section; Dystocia; Female; Fetal Diseases; Fetus; Humans; Intestinal Diseases; Meconium; Obstetrics; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Abnormalities, Multiple; Colon; Humans; Infant, Newborn; Male; Meconium; Mesoderm; Neural Tube Defects; Notochord; Pancreas; Peritonitis; Radiography; Syndrome

We report on a patient with atresia of the colon transversum and a large meconium pseudocyst adherent to the liver. Sonography additionally revealed multiple cystic structures due to intrahepatic meconium masses. Surgical evacuation of the meconium pseudocyst resulted in massive diffuse hemorrhage from the liver which could not be stopped. The child died intraoperatively due to hemorrhagic shock. Histologically the intrahepatic meconium masses were surrounded by various degrees of necrosis and hemorrhage without a well-defined capsule of fibrous granulation tissue.

Topics: Colonic Diseases; Cysts; Fatal Outcome; Humans; Infant, Newborn; Intestinal Perforation; Liver Diseases; Male; Meconium; Peritonitis; Ultrasonography

Topics: Adult; Cystic Fibrosis; Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Intestinal Obstruction; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Ultrasonography, Prenatal

We present a case of recurrent meconium peritonitis detected in the second trimester and treated by intrauterine intervention. Antenatal ultrasound findings included fetal ascites and intra-abdominal calcification. Aspiration of fetal ascites under ultrasound guidance and determination of the bilirubin concentration established the diagnosis of meconium peritonitis. Paracentesis was repeated to remove irritating intestinal contents and to decrease pressure on the fetal thorax. Although the exact cause of the meconium peritonitis remains unknown, the recurrence of the condition suggests a genetic basis. A possibility of cystic fibrosis was not considered because the clinical picture did not suggest it. Intrauterine intervention helped to establish the diagnosis of meconium peritonitis and may have contributed to the good outcome.

Topics: Adult; Ascites; Female; Fetal Diseases; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Second; Prenatal Diagnosis; Recurrence; Ultrasonography, Prenatal; Uterus

A case of meconium peritonitis that was diagnosed ultrasonographically in the second trimester is presented. Fetal ascites, intra-abdominal calcification and polyhydramnios were detected on antenatal ultrasonography.

Topics: Ascites; Cesarean Section; Fatal Outcome; Female; Fetal Diseases; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Tissue Adhesions; Ultrasonography, Prenatal

Topics: Humans; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis; Tissue Adhesions; Ultrasonography

Meconium peritonitis is a rare occurrence in neonates. Experience in its management is presented, while also attempting to compare present results with previous reports.. Between 1983 and 1993, 10 patients of meconium peritonitis were studied retrospectively. Clinical pictures, image studies, course and management were reviewed thoroughly.. There were seven males and three females, with two premature births. None of these patients had associated cystic fibrosis. The symptoms and signs presented within one week after birth, with abdominal distension being the most common manifestation (90%). Radiographic evidence of intraperitoneal calcified plaques or masses were present in only half of our patients. Surgery was performed in eight, of whom four had primary bowel obstructions. The most common site of bowel perforation was at the terminal ileum (six patients). Two patients who did not receive surgical intervention were diagnosed radiographically and sonographically, and showed cystic type meconium peritonitis. The outcome of these patients has been good except for one who died of sepsis.. The low mortality rate (10%) in this series may depend in part on successful prenatal diagnosis of four patients and, in part, on continuing progress in perinatal intensive care. A better outcome in this potentially fatal disease can thus be anticipated by the cooperation of neonatologists, pediatric surgeons and obstetricians.

Topics: Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Adult; Female; Follow-Up Studies; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Prognosis; Radiography; Ultrasonography, Prenatal

A case of foetal non-immune hydrops fetalis is presented. A second gravida was referred to our department at 31 weeks' gestation after normal pregnancy course. Sonography revealed marked foetal ascites as well as a polyhydramnion. Prenatal examinations did not yield a safe diagnosis. The foetal ascites was punctured via a pigtail-catheter that was left in the foetal abdomen. This procedure was supposed to facilitate the development of foetal lungs. At 33 weeks' gestation, after spontaneous rupture of membranes, a boy was spontaneously delivered. Postpartal radiography pointed to bowel perforation. Surgery on the first day of life showed a severe meconium peritonitis following a perforation of the ileum. 22 months after this operation, the boy is physically and mentally well developed. Until now, there is no sign of mucoviscidosis. We believe that early diagnosis, the possibility of prenatal therapy and the close collaboration of disciplines made the survival of this child possible.

Topics: Colon; Female; Humans; Hydrops Fetalis; Ileum; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Adult; Diagnostic Errors; Female; Genital Neoplasms, Male; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Rubella Syndrome, Congenital; Scrotum; Ultrasonography, Prenatal

Congenital rupture of the scrotum caused by meconium peritonitis occurred in a newborn with clinical findings of the Beckwith-Wiedemann syndrome. Ruptured omphalocele and jejunal atresia were present. Surgical repair 3 hours after birth was successful.

Topics: Genital Diseases, Male; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Rupture, Spontaneous; Scrotum

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.

Topics: Albumins; Asian People; China; Diatrizoate Meglumine; Enema; Female; Humans; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Peritonitis

By chance, we had the opportunity to make serial sonographic observations of the extrusion of meconium in a case of meconium peritonitis. Inflammation leads to exudative processes and production of fluid (ascites) in the fetal abdomen. Sonography at that stage of the disease may lead to a misdiagnosis such as 'fetal ascites' or 'non-immune hydrops'. After bowel perforation and extrusion of meconium, the latter appears as a solitary mass inside fetal ascites or as disseminated echogenic masses distributed subdiaphragmatically or perihepatically. Within a couple of days, in most cases the echogenicity of the masses increases. Calcifications lead to distinct shadowing. These calcifications are often the only visible signs of a previous meconium peritonitis. Serial sonograms are essential for the management of pregnancies with meconium peritonitis. If the amount of fetal ascites does not increase and no signs of cardiovascular stagnation appear, no invasive intrauterine diagnostic and therapeutic steps are required. In none out of the nine cases was a cause found.

Topics: Adult; Ascites; Female; Fetal Diseases; Humans; Hydrothorax; Meconium; Peritonitis; Pregnancy; Pregnancy Outcome; Ultrasonography, Prenatal

Meconium peritonitis is usually the result of prenatal bowel obstruction with subsequent perforation, then the contents spread into the peritoneal cavity, which results in a sterile inflammatory reaction. The incidence ranges from 1/1500 to 1/2000, if without prenatal diagnosis and planned postnatal treatment, the mortality rate is as high as 62%. We describe three children, two with surgically, one with autoptically confirmed meconium peritonitis. All had abnormally prenatal ultrasonographic examinations. The first fetus showed a large 10 x 11 cm intra-abdominal mass with floating echogenic substances inside and with an echogenic rim. The second showed increased echogenicity with dilated bowel in abdominal cavity in one of the twin, and the third had an intra-abdominal cyst with several echogenic bands inside, fetal ascites was also noted. It is remarkable that the ultrasonographic findings were different in the three children. Two of the three children survived postoperation, one died 3 hours later after induction out at 31 weeks of gestational age due to multiple congenital anomalies.

Topics: Adult; Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Adult; Calcinosis; Female; Fetal Diseases; Humans; Meconium; Peritonitis; Pregnancy; Radiography, Thoracic; Ultrasonography, Prenatal

Meconium peritonitis is a chemical peritonitis usually resulting from antenatal bowel rupture. Prenatal ultrasound findings include ascites, intraabdominal masses, bowel dilatation and the development of intraabdominal calcifications [1-5]. The most common bowel disorders which lead to meconium peritonitis in utero are those resulting in bowel obstruction and perforation, such as small bowel atresias, volvulus and meconium ileus [1-5]. Meconium ileus is associated with cystic fibrosis in most cases, although extraluminal abdominal calcifications are usually scarce in cases of cystic fibrosis [1, 6]. Postnatal outcome for infants with meconium peritonitis depends on the etiology for bowel rupture and underlying disease.

Topics: Ascites; Cystic Fibrosis; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Meconium peritonitis results from intestinal wall perforation with meconium spillage into the peritoneum during intrauterine life. Anal atresia is associated with meconium peritonitis and is also associated with cloacal malformation. A female neonate presented with a distended abdomen, anal atresia, and meconium peritonitis as diagnosed by calcification in the peritoneal cavity on abdominal radiograph. Sonography and cystography demonstrated a cloacal malformation with perforation of the hydrocolpos and resultant spillage of meconium into the peritoneum. There was no evidence of further perforation of bowel at surgery. This unusual case of meconium peritonitis is reported.

Topics: Anus, Imperforate; Cloaca; Diagnostic Imaging; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Vagina

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.

Topics: Adult; Cytomegalovirus Infections; Female; Fetal Diseases; Humans; Immunoglobulin Allotypes; Immunoglobulin G; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Trimester, Second; Ultrasonography, Prenatal

Topics: Calcinosis; Humans; Infant; Male; Meconium; Orchiectomy; Peritonitis; Testicular Diseases; Testis

A material of 21 cases of meconium peritonitis treated by operation from 1972-1987 is presented. In four cases, intraabdominal anomaly was suspected on the basis of antenatal ultrasonography. The mortality was 19%. 57% developed symptoms during the first 24 hours, one at the age of one month and this case history is presented. Thirteen had intestinal atresia, 14 intrauterine volvulus, 7 open perforation, 13 pseudocyst, 1 gastroscisis. 2 had cystic fibrosis. Two patients are still attending the outpatient clinic on account of minor sequelae. The remainder have been discharged.

Topics: Abnormalities, Multiple; Cysts; Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Cystic Fibrosis; Female; Humans; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Parenteral Nutrition; Peritonitis; Radiography

The study of 53 patients with neonatal meconium peritonitis (MP) over a twenty-two year-period, the largest surgically-treated series at a single centre, is presented. Three different types of MP were established: Generalized, Localized and Cystic. Prognosis and surgical techniques to be used were determined by each MP type. The following survival rates achieved: for Generalized MP, 70% with "one stage" and 89% with "two stage"; for Localized MP, 80% with "one stage" and 100% with "two stage" and for Cystic MP, 57% with "two stage". The overall survival rate was 77%, rising to 85% in the last fifteen years, probably due to the advent of parenteral nutrition and advances in neonatal intensive care.

Topics: Cystic Fibrosis; Female; Humans; Infant, Newborn; Intensive Care, Neonatal; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Prognosis; Spain

A case of a premature infant with meconium peritonitis and intraperitoneal calcifications is described. The course of illness was mild and recovery complete. No evidence of congenital intestinal obstruction or cystic fibrosis was found.

Topics: Calcinosis; Humans; Infant, Newborn; Infant, Premature, Diseases; Male; Meconium; Peritonitis; Radiography

The case of a neonate presenting with respiratory distress who had an incarcerated Bochdalek hernia with perforation and meconium peritonitis and pleuritis is reported. The patient had an associated jejunal atresia in an incarcerated segment of intestine, which undoubtedly contributed to the obstruction, strangulation, and perforation in the incarcerated hernia. Gastrointestinal complications attributable to the hernia are most unusual in the neonate, and aggressive preoperative resuscitation and stabilization with the earliest possible surgical intervention are imperative features in management.

Topics: Female; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Intestinal Atresia; Jejunum; Meconium; Peritonitis; Pleurisy; Radiography; Rupture, Spontaneous

Over an eight year period (1980-1987), fifteen cases of meconium peritonitis have been studied. As it has been reported, this pathology is still very rare. Ten pregnancies have been followed on by multiple échographies and the prenatal diagnosis of meconium peritonitis, suspected as early as 24 weeks of amenorrhea, has been established in ten cases. Among these, eight infants have been operated on before twelve hours of life, and for the ninth, surgical treatment was not advocated. The most frequent cause of the pathology is a perforation above a bowel obstruction. Two had cystic fibrosis. Of the 15 infants with meconium peritonitis, nine survived, and among these, one with cystic fibrosis and the one that has not been operated. Prenatal diagnosis in meconium peritonitis is of major interest in taking care early infants that will need an urgent surgical operation in most cases.

Topics: Diagnosis, Differential; Female; Fetal Diseases; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Prognosis; Time Factors; Ultrasonography

A case of meconium peritonitis due to meconium ileus is described. The condition was detected antenatally as fetal ascites on ultrasonography. Plain X-ray of abdomen post-natally showed specks of calcification mainly at the flanks, while on ultrasonography specks of high echogenic areas were seen throughout the abdomen which has been described as "snow-storm sign". The aetiology of meconium ileus is briefly discussed.

Topics: Adult; Ascites; Diagnosis, Differential; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

Meconium peritonitis is an aseptic peritonitis that follows a perforation of the intestines in fetal life. It is a serious complication of intestinal perforation. This article reports a female newborn who was born with gestational age of 40 weeks and birth body weight of 3400 gm. She was admitted at age of 6 days, owing to persistent vomiting, abdominal distention, tachypnea and acrocyanosis since birth. The plain abdomen showed intra-abdominal calcification and intestinal distention. Under the impression of meconium peritonitis, she was treated aggressively with exploratory laparotomy, TPN and antibiotics. During operation, dense fibrous adhesions and agglutination of the intestine were found. But no intestinal perforation was noted. Culture of ascites isolated Enterobacter aerogenes. The patient's condition was gradually recovered and she was discharged at age of 32 days. According to the previous literature, meconium peritonitis is a relative rare disease with poor prognosis. So we would like to report this case.

Topics: Enterobacter; Enterobacteriaceae Infections; Female; Humans; Infant, Newborn; Meconium; Peritonitis

A newborn 2.4-kg baby girl with a prenatal diagnosis of sacrococcygeal teratoma by ultrasound had a soft cystic mass extending from the infracoccygeal region into the right buttock. The cyst contained meconium leading to a large retroperitoneal cavity. The cyst was drained through an extended buttock incision, and healed without a site of bowel perforation ever identified. Meconium pseudocyst should be included in the differential diagnosis of sacrococcygeal and buttock tumors in the newborn.

Topics: Buttocks; Cysts; Diagnosis, Differential; Female; Humans; Infant, Newborn; Meconium; Neoplasms, Germ Cell and Embryonal; Peritonitis; Teratoma

Topics: Ascites; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Ultrasonography

Meconium peritonitis is a sterile, chemical peritonitis resulting from perforation of the bowel in perinatal life. In stillbirths meconium peritonitis is extremely rare. We report the autopsy findings in three fetuses ranging from 21-39 weeks gestation in which meconium peritonitis was identified. Maternal history in two cases was suggestive of possible fetal hypoxia. No family history of cystic fibrosis was discerned. One fetus was hydropic and abdominal calcifications were noted on postmortem radiograph. Gross evidence of meconium in the peritoneal cavity, visceral adhesions, and serosal nodules were noted in two fetuses. Nodules of calcified meconium seen by microscopy were the only clues to diagnosis in the third fetus. The discovery of meconium peritonitis at autopsy may be the only residual evidence of antecedent bowel perforation. We suggest that intrauterine hypoxia may play a role in the development of meconium peritonitis in some cases.

Topics: Adult; Female; Fetal Death; Fetal Hypoxia; Humans; Hydrops Fetalis; Male; Meconium; Peritonitis; Pregnancy; Pregnancy Trimester, Second; Pregnancy Trimester, Third

Topics: Cysts; Humans; Infant, Newborn; Intestinal Diseases; Male; Meconium; Peritonitis; Radiography

Topics: Adult; Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

Topics: Adult; Calcinosis; Female; Fetal Diseases; Hernia, Inguinal; Humans; Meconium; Peritoneal Diseases; Peritonitis; Pregnancy; Radiography; Ultrasonography

Topics: Female; Humans; Ileal Diseases; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy

Spontaneous, focal gastrointestinal perforation occurred in six very low birth weight infants. The first recognized clinical sign of perforation in five of the six infants was striking blue-black discoloration of the abdominal wall. In all cases the clinical and radiographic presentations, as well as the histologic findings, were distinct from those associated with necrotizing enterocolitis. All 4 infants who underwent exploratory laparotomy and repair had excellent surgical outcomes.

Topics: Colonic Diseases; Female; Humans; Ileal Diseases; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Intestinal Perforation; Male; Meconium; Peritonitis

Topics: Calcinosis; Granuloma; Hernia, Inguinal; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Scrotum

Intraluminal meconium calcifications are a rare cause of neonatal abdominal calcifications and can easily be misinterpreted as meconium peritonitis. We report three patients with anorectal anomalies, rectourethral fistula, and intraluminal calcified meconium. Intestinal stasis and mixing of urine and meconium may be predisposing factors for the calcification of meconium. Intraluminal calcifications appear as discrete punctate flecks within the distribution of the bowel, in contrast to meconium peritonitis, where the calcifications are linear and plaque-like, occurring anywhere in the abdominal cavity and scrotum. Careful differentiation of abdominal calcifications will allow more appropriate planning of the need and timing of surgery and can suggest the possibility of other anomalies that may not be suspected initially.

Topics: Abdomen; Calcinosis; Diagnosis, Differential; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Radiography, Abdominal

Topics: Adolescent; Adult; Ascites; Bile Duct Diseases; Cecal Diseases; Child; Child, Preschool; Colonic Diseases; Cystic Fibrosis; Duodenal Diseases; Gallbladder Diseases; Gastrointestinal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Intestine, Small; Intussusception; Jaundice, Neonatal; Liver Diseases; Male; Meconium; Peritonitis; Prenatal Diagnosis; Tomography, X-Ray Computed; Ultrasonography

Antenatal appendicular perforation leading to localized meconium peritonitis and intestinal obstruction is reported in a premature neonate. The baby was successfully treated by a limited ileocaecal resection.

Topics: Appendicitis; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Premature, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Pregnancy; Rupture, Spontaneous

Topics: Humans; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Peritonitis

Topics: Adult; Female; Fetal Diseases; Humans; Meconium; Peritonitis; Pregnancy

Topics: Adult; Edema; Female; Fetal Diseases; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

In this case report the cystic form of meconium peritonitis is presented. The aetiology and differential diagnosis of this rare entity are discussed.

Topics: Cysts; Humans; Ileum; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Ultrasonography

Topics: Calcinosis; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Radiography

A child with cystic fibrosis developed the meconium ileus equivalent in the postappendectomy period. This problem has not been emphasized in patients with cystic fibrosis. Operative evacuation only partially relieved the obstruction. Transient upper gastrointestinal bleeding fortuitously produced beneficial effect, which completely resolved the persisting ileus.

Topics: Appendectomy; Appendicitis; Child, Preschool; Cystic Fibrosis; Feces; Humans; Intestinal Obstruction; Male; Meconium; Peritonitis; Postoperative Complications

We describe three children with surgically confirmed meconium peritonitis. All had abnormal prenatal ultrasonographic examinations. The first child showed multiple cysts, the second had hydrops fetalis, and the third had dilated bowel loops. A polyhydramnion was common to all three cases. Of the two children who died, one had cystic fibrosis. It is remarkable that the ultrasonographic findings were different in the three children.

Topics: Colon; Female; Follow-Up Studies; Humans; Ileum; Infant; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

Topics: Adult; Calcinosis; Female; Humans; Ileal Diseases; Infant, Newborn; Intestinal Obstruction; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

Topics: Adult; Ascitic Fluid; Female; Humans; Infant, Newborn; Intestinal Perforation; Jejunum; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

Topics: Humans; Infant, Newborn; Male; Meconium; Peritonitis

An autopsy case of meconium peritonitis is described. This baby was born at 24 weeks of gestation. The pathological findings were generalized peritonitis and this inflammation spread to the umbilical cord. It can be thought that the cause of premature labor may be in part some inflammatory process.

Topics: Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Meconium; Peritonitis; Pregnancy; Umbilical Cord

According to the difficulties in communication with babies and very young children there often are problems in the early diagnosis of abdominal pain or symptoms. This is demonstrated in the example of appendicitis in children and meconium peritonitis in the newborns. The possibilities of pain measuring in newborn or preterm babies are shortly discussed.

Topics: Abdomen; Abdomen, Acute; Appendicitis; Child; Child, Preschool; Diagnosis, Differential; Humans; Infant; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis

Meconium pleuritis developed in a neonate with a perforation of the sigmoid colon, through a diaphragmatic defect. The meconium released in the abdomen communicated with the right pleural space. The association of these defects is unusual, and the cytologic diagnosis of meconium pleuritis has not been previously reported.

Topics: Colonic Diseases; Cytodiagnosis; Hernia, Diaphragmatic; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pleurisy; Radiography

Topics: Cesarean Section; Female; Granuloma; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Puerperal Disorders; Vernix Caseosa

The etiology of bowel perforations leading to meconium peritonitis was investigated in an attempt to explain the occurrence of such perforations in the absence of primary intestinal obstruction. Bowel specimens from 22 patients who had presented with meconium peritonitis during a 15-year period, as well as specimens from five patients with intestinal atresia without associated meconium peritonitis, were re-evaluated microscopically. An extensive review of the literature concerning meconium peritonitis, involving 1,084 patients, was compared with the results of a retrospective study of 69 patients from The Netherlands. In approximately 50 per cent of these cases there was no detectable primary cause of the bowel perforation. The pathologic findings, in combination with earlier experimental studies, indicate that vascular insufficiency may result in bowel wall perforation without prior intestinal obstruction. It is suggested that temporary decrease of mesenteric blood flow could lead to intestinal atresia and/or meconium peritonitis.

Topics: Birth Weight; Cystic Fibrosis; Gestational Age; Humans; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Intestines; Meconium; Peritonitis; Splanchnic Circulation

Topics: Calcinosis; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Radiography; Thoracic Diseases

Although uncommon, meconium peritonitis can present with a scrotal mass. Usually calcified, this mass may be the initial or only sign of meconium peritonitis. We detected such a scrotal mass prenatally with ultrasound.

Topics: Adolescent; Female; Genital Diseases, Male; Humans; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Scrotum; Testicular Hydrocele; Ultrasonography

Topics: Adolescent; Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

In recent years patients with cystic fibrosis (CF) have experienced longterm survival and have demonstrated a number of intra-abdominal complications. This report evaluates the intra-abdominal complications seen in 69 of 189 children with cystic fibrosis from 1972 to 1983. Forty-one patients were boys and twenty-eight girls. Complications occurred in 36 neonates, with meconium ileus (MI) noted in 33 and giant cystic meconium peritonitis (GCMP) in 3. Meconium ileus equivalent occurred in seven older children presenting with bowel obstruction. In addition, rectal prolapse occurred in 12, inguinal hernia in 10, intussusception in 3, cholelithiasis in 3, GE reflux in 4, stress ulcer in 1 and appendicitis in 1. Three infants with GCMP survived resection and enterostomy. Infants with MI were divided into simple (15) or complicated (18) cases. Nonoperative therapy using gastrografin enema was successful in three of eight with simple MI. Operative enterotomy and irrigation was successful in three cases while resection and enterostomy was done in nine. MI was complicated by atresia, volvulus and/or perforation in 18 cases requiring resection and anastomosis or enterostomy. Survival for MI was 86% compared to 36% in 25 MI patients treated in the previous two decades. Meconium ileus equivalent was successfully managed using gastrografin enema in five of seven children. Only 3 of 12 children with rectal prolapse required repair. Two cases of intussusception were reduced while one required resection. Three of 10 children had hernia recurrence due to chronic pulmonary problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Abdomen; Adolescent; Child; Child, Preschool; Cystic Fibrosis; Female; Hernia, Inguinal; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Intussusception; Male; Meconium; Peritonitis; Rectal Prolapse

We report on the prenatal diagnosis of a case of foetal meconium peritonitis pursuant to colon perforation in the 34th week of gestation. A sonographic examination of the foetus showed ascites, dense zones around the peritoneum and intestine, hepatosplenomegaly and hydroceles, as well as a slight hydramnios. The foetal abdomen was punctured under ultrasonographic control, and ascitic fluid was withdrawn. It was sterile but included granulocytes, leucocytes, epidermal epithelial cells and lanugo hairs, thereby confirming the diagnosis. The bilirubin concentration was very high, and the protein content was also increased. An amniofoetography gave a clear picture of the small intestine and showed a calcified zone in the upper left abdomen. A Caesarean section was performed prior to term, and the prenatal diagnosis was confirmed. After surgical correction the infant has developed satisfactorily up to the present age of 15 months, even though mucoviscidosis was diagnosed at the age of 5 months. In addition to ascites due to meconium peritonitis, several other types of foetal ascites are discussed.

Topics: Adult; Ascitic Fluid; Diagnosis, Differential; Female; Fetal Diseases; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

A case of meconium peritonitis that was diagnosed ultrasonographically in the early third trimester in a patient with acute polyhydramnios is presented. The pathophysiologic progression of this condition is demonstrated by serial ultrasound examinations. Neonatal radiologic confirmation of the diagnosis is also presented. The obstetric and neonatal implications of meconium peritonitis and the importance of serial ultrasonography in those pregnancies in which this diagnosis is made are discussed.

Topics: Adult; Female; Fetal Diseases; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Pregnancy Trimester, Third; Ultrasonography

Topics: Adult; Cysts; Female; Humans; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

Topics: Cysts; Humans; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis

Topics: Diagnosis, Differential; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Radiography

Meconium peritonitis being a rare anomaly, it is difficult to find the factors that determine the prognosis. In spite of the high mortality, this aspect has hardly ever been studied. A retrospective study of 69 patients from the Netherlands over a 15 year period, revealed that a patient with pneumoperitoneum and a generalized type of meconium peritonitis has a relatively favourable prognosis. Despite a more optimistic outlook expressed in recent publications, an overview of the world literature involving 1084 patients shows that the mortality for this disease has not dropped in the past 15 years and still amounts to 55%.

Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Postoperative Complications; Pregnancy; Prognosis; Retrospective Studies

Topics: Genital Diseases, Male; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Rupture, Spontaneous; Scrotum

Meconium peritonitis occasionally occurs as a localized, encysted collection of meconium ranging from a few centimeters in size to huge cysts occupying most of the abdominal cavity. The cyst wall consists of fibrous granulation tissue and the cyst may contain only meconium or may also encase loops of bowel. Gas within the cyst indicates persistent communication between the perforated bowel and the cyst cavity; if the perforation seals over in utero the cyst remains gasless. Calcification is a variable finding. Sonography in two neonates with cystic meconium peritonitis showed well-defined, echogenic masses, one of which contained calcifications and was detected in utero.

Topics: Adolescent; Cysts; Female; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography

Topics: Humans; Infant, Newborn; Male; Meconium; Peritonitis; Ultrasonography

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.

Topics: Calcinosis; Child, Preschool; Female; Granuloma, Giant Cell; Humans; Infant; Infant, Newborn; Male; Meconium; Peritonitis

Topics: Adult; Calcinosis; Cysts; Diagnosis, Differential; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Prenatal Diagnosis; Prognosis; Ultrasonography

The radiographic findings of 200 cases of meconium peritonitis were analyzed; 194 cases were discovered in newborn infants and six cases in fetuses. The radiographic features in the newborn group could be categorized as pneumoperitoneum with intestinal obstruction (adhesions) and calcification (35 cases), intestinal obstruction with calcification (143 cases), intestinal obstruction with no radiographically visible calcification (5 cases), and calcification alone (11 cases). All six cases of the fetal group were diagnosed when the mothers had been hospitalized for polyhydramnios and a plaque-like or ring-like calcification showed up in the fetal abdomen on the plain radiograph. Meconium peritonitis is one of the few conditions that can be diagnosed before birth and is almost the only condition around the time of birth to produce calcification in the abdomen. Therefore, if there is any sign of polyhydramnios, radiographs or ultrasonograms of the maternal abdomen should be obtained to detect any calcification within the peritoneal cavity of the fetus. A simple experiment carried out in rats showed that it takes at least eight days after the meconium escapes into the peritoneal cavity for calcification in the meconium to be radiographically demonstrable.

Topics: Adult; Calcinosis; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Peritonitis; Pneumoperitoneum; Polyhydramnios; Pregnancy; Radiography

The prenatal diagnosis of fetal bowel obstruction with perforation and meconium peritonitis is described. Characteristic ultrasound findings include polyhydramnios, fetal ascites, and echogenic calcific foci with acoustical shadowing.

Topics: Adult; Calcinosis; Female; Fetal Diseases; Humans; Intestinal Perforation; Male; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Ultrasonography

Topics: Abdomen; Adult; Ascites; Diagnosis, Differential; Erythroblastosis, Fetal; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography

Topics: Female; Fetal Diseases; Humans; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

This paper reports on a preterm infant with meconium peritonitis in which prenatal sonography demonstrated calcified peritoneal meconium associated with fetal ascites. His spontaneous and favorable outcome is described and other causes of neonatal abdominal calcifications are discussed.

Topics: Ascites; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Premature; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

Topics: Abnormalities, Multiple; Hernia, Diaphragmatic; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pneumothorax; Radiography

Topics: Congenital Abnormalities; Cysts; Humans; Infant, Newborn; Male; Meconium; Peritonitis

Although sonography is the procedure of choice in evaluating testicular masses in infants, x-ray examination can confirm the diagnosis of healed meconium peritonitis by showing scattered intra-abdominal as well as intrascrotal calcifications. Failure to include an abdominal radiograph early in the evaluation of 2 infants admitted with hard scrotal masses resulted in delayed diagnosis of healed meconium peritonitis. The clinical progression of meconium peritonitis involving the scrotum starts with soft hydroceles at birth and progresses, as the meconium calcifies, to hard "tumor-like" masses at age 4-5 weeks. This paper stresses the sonographic characteristics of meconium peritonitis in the scrotum and the need for confirming radiographs of the abdomen.

Topics: Calcinosis; Diagnosis, Differential; Genital Diseases, Male; Genital Neoplasms, Male; Humans; Infant; Infant, Newborn; Male; Meconium; Peritonitis; Scrotum; Ultrasonography

Topics: Adult; Ascites; Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

In 20 years the authors have met with 115 cases of meconium peritonitis (MP). The high incidence in China is shown. In all cases there were intraabdominal calcifications. There were no cases of fibrocystic disease. The authors classify 3 types: 1. Neonatal obstructive type 41 cases. 2. Free perforation with: Free pneumoperitoneum 15 cases. Localized pneumoperitoneum 23 cases. 3. No signs or symptoms, with potential intestinal obstruction 23 cases. The series shows a low incidence of atresia. The authors suggest necrotizing enterocolitis as a cause because of the high incidence of stenosis. Three prenatally diagnosed cases are discussed. All had hydramnios and fetal abdominal calcifications. Two of these were confirmed after birth. The mortality is high (42.6%). Abdominal x-ray in all cases with polyhydramnios may lead to a positive diagnosis of MP.

Topics: Abdomen; Adult; Calcinosis; China; Enterocolitis, Pseudomembranous; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Pneumoperitoneum; Polyhydramnios; Pregnancy; Prenatal Diagnosis

Topics: Ascites; Calcinosis; Female; Fetal Diseases; Humans; Ileum; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Ultrasonography

Topics: Cysts; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Child; Chlorides; Cholestasis, Intrahepatic; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Sweat; Syndrome

Topics: Adult; Cysts; Edema; Female; Fetal Diseases; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pregnancy; Radiography

Twelve cases of meconium peritonitis were retrospectively reviewed in this study. Five of these patients had cystic fibrosis. Of the patients with cystic fibrosis, intraperitoneal calcifications were present in three (60%) and two (40%) had none. All seven patients (100%) who had meconium peritonitis without cystic fibrosis had abdominal calcifications. These results indicate that the presence of intraperitoneal calcifications does not exclude the diagnosis of cystic fibrosis and that the absence of calcification favors cystic fibrosis. However, a review of the literature indicates the absence of calcification is merely of clue and not definitive as to the etiology of the meconium peritonitis.

Topics: Calcinosis; Cystic Fibrosis; Female; Humans; Infant, Newborn; Male; Meconium; Peritoneal Diseases; Peritonitis

The diagnosis of meconium peritonitis has received little attention in the pathology literature. Morphologic features of meconium peritonitis can be confusing to the pathologist unfamiliar with this specific entity, especially in case of extraperitoneal lesions presenting clinically as tumor nodules in the tunica vaginalis. Unfamiliarity with this entity can lead to unnecessary removal of the testis. This paper describes four cases of meconium peritonitis and reviews the literature on the pathology, evolution and diagnostic features of the disease, with emphasis on the healed stage, presenting as a tumor mass in the inguinal canal or tunica vaginalis.

Topics: Calcinosis; Child, Preschool; Diagnosis, Differential; Female; Humans; Infant; Infant, Newborn; Male; Meconium; Peritonitis; Testicular Neoplasms

The case of a newborn infant with small-intestine atresia coexisting with segmental absence of muscle coats leading to perforation and meconium peritonitis is presented. The theories of pathogenesis of the simultaneous occurrence of segmental absence of gut musculature and atresia are briefly reviewed. A possible etiologic role of vascular accident in utero for both conditions is discussed.

Topics: Female; Humans; Infant, Newborn; Intestinal Atresia; Intestine, Small; Meconium; Muscles; Peritonitis

Topics: Cysts; Humans; Infant, Newborn; Intestinal Diseases; Male; Meconium; Peritonitis

Topics: Adult; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Perforation; Intestine, Small; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Rupture, Spontaneous; Ultrasonography

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.

Topics: Barium Sulfate; Cystic Fibrosis; Female; Hirschsprung Disease; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Obstruction; Male; Meconium; Peritonitis; Retrospective Studies

Topics: Abscess; Animals; Calcinosis; Cystic Fibrosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritoneal Diseases; Peritonitis; Radiography; Rats

Topics: Calcinosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Radiography

Topics: Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Orchitis; Peritonitis; Pregnancy

A 32-year-old woman underwent cesarean section because of fetal distress. Meconium spilled into the incision during delivery. The patient subsequently had a fever, right-sided pleuritic chest pain, a right lower lobe infiltrate, and a pleural effusion. Exploratory laparotomy disclosed intra-abdominal fibrosis with inflammatory mass formation. A biopsy specimen showed a granulomatous reaction around the bile-staining material similar to meconium. The patient was treated with prednisone, and her symptoms abated. During the next four years, episodes of fever, abdominal discomfort, and pleuritis recurred, which eventually responded to indomethacin therapy.

Topics: Adult; Cesarean Section; Female; Fetal Distress; Humans; Infant, Newborn; Meconium; Omentum; Peritonitis; Pleural Effusion; Pregnancy

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.

Topics: Cysts; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Radiography

Topics: Esophageal Atresia; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis; Sigmoid Diseases

An evaluation of patients with meconium peritonitis shows that, apart from the fibro-adhesive type, the (Pseudo) cystic and the generalized type, a fourth type can be distinguished. In a case of this fourth type, the "microscopic" type of meconium peritonitis, no signs of a peritonitis are found on macroscopic examination of the abdominal cavity. Conversely, microscopic examination will reveal meconium components focally outside the bowel. The clinical and histological data of 14 patients are discussed. It is pointed out that a significantly large number of patients with meconium peritonitis also have atresia of the small bowel. Based on the patient evaluation, a hypothesis is brought forward concerning the pathogenesis of these atresias.

Topics: Female; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Jejunum; Male; Meconium; Peritonitis

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis

In chick embryos we studied the effect on intestinal development of an experimentally induced perforation and a vascular lesion performed at an early developmental stage. The results show that an intestinal perforation will heal, but may lead to intestinal atresia with microscopic signs of meconium peritonitis. Conversely, a vascular lesion induced at an early stage of development does not lead to intestinal atresia, while a vascular lesion performed at a late stage of development does result in intestinal atresia, but without any signs of meconium peritonitis.

Topics: Animals; Chick Embryo; Intestinal Atresia; Intestinal Perforation; Intestines; Meconium; Peritonitis; Splanchnic Circulation; Wound Healing

Topics: Autopsy; Esophageal Atresia; Humans; Infant, Newborn; Male; Meconium; Peritonitis

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Radiography

Topics: Adult; Ascites; Calcinosis; Diagnosis, Differential; Female; Fetal Diseases; Humans; Ileal Diseases; Infant, Newborn; Intestinal Perforation; Meconium; Peritonitis; Pregnancy; Ultrasonography

Topics: Adult; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis; Radiography; Ultrasonography

The authors report six cases of meconium peritonitis with intra-abdominal calcifications; surgical intervention was successful in four. In five patients, fibrocystic desease of pancreas was eliminated. Presenting this report, it is their intention to underline the good prognosis of calcifications which generally eliminate the meconium ileus.

Topics: Calcinosis; Cystic Fibrosis; Diagnosis, Differential; Female; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Radiography

A newborn infant, who had suffered intrauterine perforation and had developed peritoneal calcification, showed no sign of pneumoperitoneum on the first radiograph taken 3 hours after delivery. At that time air was present in the stomach only. Subsequently pneumoperitoneum developed as air passed down the gut to the point of perforation. Thus, the absence of pneumoperitoneum on a radiograph taken very early in life does not exclude an intestinal perforation.

Topics: Colonic Diseases; Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pneumoperitoneum; Pregnancy; Radiography

Topics: Humans; Ileal Diseases; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis; Prognosis; Radiography

Topics: Humans; Ileum; Infant, Newborn; Male; Meconium; Peritonitis; Radiography

Although NSLCS has been considered to have a benign course, we have described an infant who had intrauterine intestinal perforation and meconium peritonitis associated with the NSLCS. Infants of diabetic mothers who are stillborn or who develop abdominal distention shortly after delivery should be suspected of having this complication of NSLCS. This disorder must also be considered in the differential diagnosis of infants who present with meconium peritonitis.

Topics: Colonic Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Meconium; Peritonitis; Syndrome

After a short literature a review a comparison is made between the development of the human digestive tract during the second trimester of gestation and that of the chick embryo (Gallus domesticus) during the last week of incubation. The surgical procedure for chick embryosis is discussed in connection with the the study of the pathogenesis of small bowel atresia and meconium peritonitis. The results corroborate that the chick embryo is a valuable laboratory animal in experimental fetal surgery.

Topics: Animals; Chick Embryo; Disease Models, Animal; Female; Humans; Intestinal Atresia; Intestine, Small; Meconium; Peritonitis; Pregnancy; Pregnancy Trimester, Second

Topics: Brain Diseases; Candidiasis; Cerebral Aqueduct; Diseases in Twins; Female; Humans; Infant, Newborn; Meconium; Meningitis; Parenteral Nutrition; Peritonitis

Topics: Adult; Amniotic Fluid; Bilirubin; Colon; Diseases in Twins; Erythroblastosis, Fetal; Female; Humans; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis

Topics: Genital Diseases, Male; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Scrotum

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Ischemia; Meconium; Peritonitis; Radiography; Rupture, Spontaneous; Stomach; Stomach Rupture

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Meconium; Peritonitis

Topics: Adult; Female; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Male; Meconium; Peritonitis; Pregnancy; Radiography

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis; Radiography

Topics: Female; Humans; Ileum; Infant, Newborn; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Rupture, Spontaneous

Apparently spontaneous neonatal intestinal perforation may be difficult to diagnose if the condition is not kept in mind. It may present with free perforation or with the late effects of meconium peritonitis. Five cases are described. There is a high mortality associated with bacterial peritonitis, and the importance of early diagnosis and energetic resuscitation is underlined.

Topics: Colonic Diseases; Female; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Jejunum; Male; Meconium; Peritonitis; Rupture, Spontaneous; Stomach Rupture

Topics: Adult; Diseases in Twins; Female; Humans; Infant, Newborn; Meconium; Peritonitis; Radiography

Meconium peritonitis results from perforation of the gastrointestinal tract during fetal life. Involvement of the tunica vaginalis may be the sole presenting clinical manifestation of the disease in the unusual event of the gut perforation resolving spontaneously. In such instances radiologically detectable calcification in the abdomen and scrotum is an essential diagnostic point. A case is described in which a baby had hydroceles and bilateral intrascrotal nodules but in which calcification was radiologically undetectable, presumably owing to its having undergon resolution. The typical histology of the nodules provided the diagnosis in this otherwise clinically undiagnostic case.

Topics: Calcinosis; Epididymis; Granuloma; Humans; Infant; Male; Meconium; Peritonitis; Radiography, Abdominal; Scrotum; Testicular Hydrocele; Testis

Topics: Animals; Animals, Newborn; Bacterial Infections; Female; Guinea Pigs; Meconium; Peritoneum; Peritonitis; Pregnancy; Suppuration; Tissue Adhesions

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Methods; Peritonitis

Topics: Calcinosis; Castration; Cystic Fibrosis; Humans; Infant; Male; Meconium; Peritonitis; Scrotum

Topics: Bronchopneumonia; Female; Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Calcinosis; Constipation; Female; Fetal Diseases; Gastrointestinal Motility; Humans; Infant; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Pregnancy; Radiography, Abdominal; Time Factors; Tissue Adhesions; Vomiting

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Meconium; Peritonitis

Topics: Adult; Calcinosis; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inguinal Canal; Male; Meconium; Peritonitis; Radiography; Testis

Topics: Calcinosis; Female; Fetal Diseases; Hernia; Humans; Infant; Intestinal Obstruction; Intestinal Perforation; Jejunum; Male; Meconium; Peritonitis; Pregnancy; Radiography; Tissue Adhesions

Topics: Abdomen; Calcinosis; Cystic Fibrosis; Cysts; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Pregnancy; Radiography; Umbilicus

Topics: Ascites; Dystocia; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Atresia; Intestine, Large; Meconium; Peritonitis; Pregnancy

Topics: Appendicitis; Child; Child, Preschool; Diagnosis, Differential; Enterocolitis, Pseudomembranous; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Intussusception; Meckel Diverticulum; Meconium; Pancreatitis; Peptic Ulcer Perforation; Peritonitis; Radiography

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Radiography

Topics: Abdomen, Acute; Cysts; Diagnosis, Differential; Digestive System Abnormalities; Female; Follow-Up Studies; Hemangioma; Humans; Hydronephrosis; Infant, Newborn; Infant, Newborn, Diseases; Kidney Diseases; Kidney Neoplasms; Liver Neoplasms; Male; Meconium; Neuroblastoma; Ovarian Cysts; Peritonitis; Polycystic Kidney Diseases; Renal Veins; Retroperitoneal Neoplasms; Stomach Neoplasms; Teratoma; Thrombophlebitis; Uterine Diseases; Vaginal Diseases

Topics: Achondroplasia; Adult; Calcinosis; Humans; Infant; Lumbar Vertebrae; Male; Meconium; Middle Aged; Peritonitis; Radiography

Topics: Autopsy; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Acute Disease; Autopsy; Chronic Disease; Colon, Sigmoid; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Meconium; Muscle, Smooth; Peritonitis; Pregnancy; Tissue Adhesions

Topics: Contrast Media; Cystic Fibrosis; Diatrizoate; Enema; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Peritonitis; Radiography

Topics: Female; Humans; Infant; Meconium; Methylene Blue; Peritonitis; Polymyxins; Pseudomonas aeruginosa; Sulfaphenazole

Topics: Colonic Diseases; Cystic Fibrosis; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Radiography

Topics: Diagnosis, Differential; Dilatation; Female; Genital Diseases, Female; Genitalia, Female; Humans; Hymen; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis; Radiography

Topics: Adult; Female; Fetal Death; Fetal Diseases; Humans; Infant, Newborn; Intestinal Perforation; Intestine, Small; Meconium; Obstetric Labor Complications; Peritonitis; Pregnancy

Topics: Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Methods; Peritonitis; Postoperative Complications

Topics: Anus, Imperforate; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Laparotomy; Male; Meconium; Peritonitis; Philosophy, Medical; Pregnancy; Prenatal Care; Radiography; Torsion Abnormality

Topics: Female; Gestational Age; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Pregnancy

Topics: Bone Development; Female; Femur; Humans; Humerus; Ilium; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Peritonitis; Pregnancy; Radiography; Scapula

Topics: Cysts; Humans; Infant, Newborn; Intestinal Obstruction; Intestine, Small; Male; Meconium; Peritonitis

Topics: Duodenal Diseases; Duodenal Ulcer; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Diseases; Intestinal Obstruction; Intestinal Perforation; Intestine, Small; Intussusception; Laparotomy; Meckel Diverticulum; Meconium; Methods; Peritonitis; Suture Techniques; Time Factors

Topics: Ampulla of Vater; Cystic Fibrosis; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Radiography

Topics: Abdomen; Adult; Female; Fistula; Humans; Ileum; Infant, Newborn; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Scrotum

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Calcinosis; Genital Diseases, Male; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Male; Meconium; Peritonitis; Scrotum

Topics: Adult; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Meconium; Pancreatic Diseases; Peritonitis; Pregnancy

Topics: Abdomen, Acute; Collateral Circulation; Cystic Fibrosis; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Intestines; Male; Meconium; Peritoneum; Peritonitis; Pneumoperitoneum; Pregnancy; Radiography, Abdominal; Sepsis; Stomach Rupture

Topics: Calcinosis; Diagnosis, Differential; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Radiography; Scrotum; Teratoma; Testicular Hydrocele; Testicular Neoplasms

Topics: Female; Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Colostomy; Enterocolitis, Pseudomembranous; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Jejunum; Male; Meconium; Peptic Ulcer Perforation; Peritonitis; Pneumoperitoneum; Radiography; Sepsis; Stomach

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Nursing; Peritonitis

Topics: Anti-Bacterial Agents; Colitis; Enema; Female; Hernia, Umbilical; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Meconium; Peritonitis; Pneumoperitoneum

Topics: Cysts; Female; Fetal Diseases; Humans; Hyperbilirubinemia; Infant, Newborn; Intestinal Obstruction; Intestinal Perforation; Intestine, Small; Meconium; Obstetric Labor Complications; Perineum; Peritonitis; Pregnancy

Topics: Ascites; Cysts; Female; Humans; Infant; Intestinal Obstruction; Laparotomy; Male; Meconium; Peritonitis

Topics: Abdomen; Adult; Dystocia; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Pregnancy; Radiography

Topics: Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meckel Diverticulum; Meconium; Peritonitis; Surgical Procedures, Operative

Topics: Animals; Female; Guinea Pigs; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Research

Topics: Cystic Fibrosis; Diseases in Twins; Female; Humans; Infant, Newborn; Infant, Premature, Diseases; Intestinal Atresia; Intestine, Small; Male; Meconium; Peritonitis

Topics: Calcinosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Diaphragmatic Eventration; Female; Fetal Diseases; Humans; Infant, Newborn; Male; Meconium; Peritonitis; Pleurisy; Pregnancy

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis

Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Meconium; Peritonitis; Pregnancy

Topics: Autopsy; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Radiography

Topics: Diagnosis; Humans; Infant; Infant, Newborn; Intestinal Atresia; Intestine, Small; Intestines; Meconium; Mortality; Peritonitis; Radiography; Surgical Procedures, Operative

Topics: Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Postoperative Care; Radiography; Surgical Procedures, Operative

Topics: Calcinosis; Congenital Abnormalities; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Surgical Procedures, Operative

Topics: Diagnosis; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pathology; Peritonitis; Surgical Procedures, Operative

Topics: Congenital Abnormalities; Cystic Fibrosis; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Meconium; Pathology; Peritonitis; Surgical Procedures, Operative

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Liver Diseases; Meconium; Megacolon; Peritonitis; Pseudomonas Infections; Radiography; Sepsis

Topics: Calcinosis; Gastric Fistula; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Intestinal Fistula; Meconium; Peritonitis; Radiography; Surgical Procedures, Operative

Topics: Adrenal Gland Diseases; Congenital Abnormalities; Emergencies; Esophagus; Hemorrhage; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Meconium; Peritonitis; Radiography

Topics: Acetylcysteine; Cysteine; Cystic Fibrosis; Fetal Diseases; Hernia, Umbilical; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Surgical Procedures, Operative

Topics: Calcinosis; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritoneum; Peritonitis; Scrotum

Topics: Fetal Diseases; Fetus; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Testicular Hydrocele

Topics: Fetal Diseases; Granuloma; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Perforation; Meckel Diverticulum; Meconium; Pathology; Peritonitis

Topics: Feces; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Umbilical Cord

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Surgical Procedures, Operative

Topics: Fetal Diseases; Humans; Infant; Infant, Newborn; Meconium; Peritonitis

Topics: Abdomen; Abdomen, Acute; Cystic Fibrosis; Gastrointestinal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Meconium; Megacolon; Peritonitis; Surgical Procedures, Operative

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Radiography; Radiology

Topics: Cystic Fibrosis; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Meconium; Peritonitis; Survivors

Topics: Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Meconium; Peritonitis; Radiography; Surgical Procedures, Operative

Topics: Contrast Media; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Volvulus; Meconium; Peritonitis; Radiography; Surgical Procedures, Operative

Topics: Adrenal Insufficiency; Congenital Abnormalities; Cysts; Hernia, Umbilical; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Diseases; Intestinal Obstruction; Intussusception; Meconium; Megacolon; Mesenteric Vascular Occlusion; Pathology; Peritonitis; Surgical Procedures, Operative

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Medical Records; Peritonitis

Topics: Child; Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis

Topics: Humans; Infant, Newborn; Intestinal Obstruction; Intestine, Small; Intestines; Meckel Diverticulum; Meconium; Peritonitis; Polyps

Topics: Fetal Diseases; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestine, Small; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Fetus; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pancreas; Pancreatic Diseases; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Intestinal Atresia; Intestines; Meconium; Peritonitis

Topics: Child; Disease; Female; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Uterine Perforation

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Drainage; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis; Physical Examination

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Osteosclerosis; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Ascites; Child; Dystocia; Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis; Pregnancy

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meckel Diverticulum; Meconium; Peritonitis; Rupture

Topics: Amniotic Fluid; Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis

Topics: Child; Diaphragm; Humans; Infant; Infant, Newborn, Diseases; Meconium; Mucous Membrane; Peritonitis; Stomach Diseases

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intussusception; Meconium; Peritonitis

Topics: Child; Disease; Humans; Infant; Infant, Newborn, Diseases; Meconium; Pancreas; Pancreatic Diseases; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Abscess; Child; Humans; Infant; Infant, Newborn; Intestinal Obstruction; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritoneum; Peritonitis

Topics: Child; Duodenum; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Minnesota; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Premature, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Calcification, Physiologic; Calcinosis; Child; Disease; Genital Diseases, Male; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Scrotum

Topics: Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis

Topics: Child; Disease; Hernia; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestines; Meconium; Mesentery; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Disease; Humans; Ileum; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Volvulus; Meconium; Pancreas; Pancreatic Diseases; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Congenital Abnormalities; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Megacolon; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Dystocia; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis; Pregnancy

Topics: Cystic Fibrosis; Disease; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pancreas; Pancreatic Diseases; Peritonitis

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Intestines; Meconium; Peritonitis

Topics: Colon, Transverse; Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Jejunum; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Adhesives; Animals; Fallopian Tubes; Female; Fetal Diseases; Fetus; Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Fetus; Humans; Infant, Newborn; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Abscess; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestines; Meconium; Peritonitis