Meconium peritonitis presenting as giant cysts in neonates

Kolawole, T. M.; Bankole, Michael A.; Olurin, E. O.; Familusi, J. B.

doi:10.1259/0007-1285-46-551-964

Cited by 19 publications

(15 citation statements)

References 9 publications

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“…The mortality rate becomes very high when they were operated on after the first 24 hours of life. 4,8 In Nigeria 9,10 and Africa 7,11 there is paucity of literature on MP as all were case reports. This is a multicenter study on all cases of MP presenting to us with highlights of the peculiar presentation and outcome of treatment.…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

Meconium peritonitis in Nigerian Children

et al. 2008

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“…The perforation may seal over before birth or may remain open between the bowel lumen and the cyst cavity [19]. Meconium cysts vary in size from small, initially asymptomatic ones [24] to socalled "giant" cysts which occupy virtually the entire peritoneal cavity [14,15,19].…”

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confidence: 99%

“…It is well known to surgeons [3,6,[15][16][17][18][19]21] but has, until recently [5,7,8], received little attention in the radiologic literature [14,22]. We were attuned to cystic meconium peritonitis from previous experience [8] and recently performed sonograms on two additional patients with this condition.…”

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confidence: 99%

Cystic meconium peritonitis: ultrasonographic features

et al. 1984

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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.

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“…Giant cystic meconium peritonitis has been described infrequently [5,6]. Radiologically, a large air fluid level with peripheral calcification in a case with abdominal distension is very suggestive of meconium pseudocyst [2,6]. The underlying pathology leading to me-MJAFI, 51 : 3, July 1995 conium peritonitis varies.…”

Section: Discussionmentioning

confidence: 99%

“…Extravasation of sterile meconium into the fetal peritoneal cavity causes an intense chemical and foreign body reaction with characteristic calcification. This is not an uncommon disease entity in neonatal life, however, formation of giant pseudocyst is rare [2]. Very few cases have been reported in Indian literature [3][4][5].…”

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confidence: 99%