morphine and Thoracic-Diseases

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

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

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

A case of meconium thorax resulting from spontaneous perforation of the colon associated with a right Bochdalek's foramen, without herniation, is presented. The baby had immediate respiratory distress postpartum resulting from the meconium in the pleural cavity. No fetal distress was detected, in spite of electrode monitoring in labor, to account for the colonic perforation.

Topics: Colonic Diseases; Female; Hernias, Diaphragmatic, Congenital; Humans; Infant, Newborn; Intestinal Perforation; Male; Meconium; Pregnancy; Respiratory Distress Syndrome, Newborn; Thoracic Diseases