Meconium peritonitis presenting as abdominal calcification: three cases with different pathology

Abstract

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.

Meconium Peritonitis: Antenatal Diagnosis and Management. Two Case Reports

“…MP is a rare condition, with a reported frequency varying between 1:30000 [15] and 1:35000 [10]. However, as some cases which occur in utero can be clinically inapparent at birth, the actual frequency might be higher [10].…”

“…MP is a rare condition, with a reported frequency varying between 1:30000 [15] and 1:35000 [10]. However, as some cases which occur in utero can be clinically inapparent at birth, the actual frequency might be higher [10]. MP is often associated with cystic fibrosis, increasing the gravity and influencing the vital prognosis of these patients [7].…”

“…MP can be simple or complex. The sole presence of intraabdominal calcifications indicates simple MP, whereas an association with ascites, pseudocyst or bowel dilatation constitutes the complex variety [10]. Zangheri et al created a classification system (Table 1) based on the 3 rd trimester US findings (which were related to the perinatal outcome) that resembles Dewan's concept, grade 0 being the equivalent of simple MP and grades I, II, III being the equivalent of complex MP.…”

“…Differential diagnosis may include multiple bowel atresia, colonic atresia, Hirschsprung's disease, high anorectal malformations and cloacal anomalies. Adrenal and liver calcifications can also be identified with cytomegalovirus, parvovirus infections or neuroblastoma, hepatoblastoma [10][11][12].…”

“…Meconium peritonitis can also be identified prenatally by diagnosing meconium through open processus vaginalis. The diagnosis of MP in the postnatal period is based on clinical findings and scrotal or abdominal radiographs and ultrasonography [10]. In patients without prenatal suspicion or diagnosis, the evidence of MP in the postnatal period is based on clinical presentation of intestinal obstruction: newborn revealing abdominal distension, vomiting, failure to pass the meconium, respiratory distress.…”