Experience with meconium peritonitis

Nam, So Hyun; Kim, Seong Chul; Kim, Dae Yeon; Kim, Ai Rhan; Kim, Ki Soo; Pi, Soo Young; Won, Hye Sung; Kim, In Koo

doi:10.1016/j.jpedsurg.2007.07.006

Cited by 80 publications

(79 citation statements)

References 19 publications

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“…Among Caucasians, meconium ileus is the commonest cause of MP and is present in 40% of postnatal cases. 1 None of our patients as in the series of Nam and colleagues 12 had features suggestive of meconium ileus even though no screening tests were carried out for cystic fibrosis as this is extremely rare in our practice.…”

Section: Resultsmentioning

confidence: 86%

“…Intestinal atresia and Hirschsprung's disease were responsible for MP in more than half of our cases, intestinal atresia was also the commonest cause of MP in a large series from South Korea. 12 In the remaining patients, the etiology was unknown as no pathology was found. This is not unusual as absence of definite pathology has been documented by earlier reports.…”

Section: Resultsmentioning

confidence: 99%

“…16 Prenatal diagnosis will facilitate perinatal management by allowing for surgery as soon as possible after birth following resuscitation, 17,18 thus avoiding the bacterial colonization that occurs after birth. This has led to reduction of operative mortality to about 2.4 to 23 per cent, 4,12,[16][17][18] when compared with the high rates in the early 1950s. 4 Only half of our patients had a supervised antenatal care with an ultrasound examination.…”

Section: Resultsmentioning

confidence: 99%

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Meconium peritonitis in Nigerian Children

et al. 2008

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Background: 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. Methods: 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. Results: 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 Xrays 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%). Conclusion: 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.

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Section: Resultsmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Meconium peritonitis in Nigerian Children

et al. 2008

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“…Reports related to MP appeared in the English literature as early as the 1830s [1] . The reported incidence of MP is low, 1 in 30,000 live births [2] . MP follows fetal gastrointestinal perforation due to congenital intestinal obstruction, such as ileal atresia, volvulus, Hirschsprung's disease, duplication, and extrinsic bands.…”

Section: Introductionmentioning

confidence: 97%

Meconium Peritonitis: Correlation of Antenatal Diagnosis and Postnatal Outcome - An Institutional Experience over 10 Years

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Rajadurai²,

Saffari³

et al. 2016

Fetal Diagn Ther

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Objective: 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. Material and Methods: We conducted a retrospective analysis of a cohort of 18 infants with MP from April 2004 to March 2014. Results: 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. Discussion: 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.

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“…Intestinal atresia, among several other causes, seems to be the most common cause of meconium peritonitis [2]. Early detection and immediate post-natal management is imperative for better outcome.…”

Section: Introductionmentioning

confidence: 99%