Meconium peritonitis secondary to torsion of fallopian tube cyst and transient central diabetes insipidus in a preterm infant

Abstract

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.

An unusual cause of meconium peritonitis in a foetus

“…The underlying causes of meconium peritonitis thus include meconium ileus, intestinal atresia, stenosis, internal hernia, neonatal Hirschsprung's disease, volvulus, intussusception, extrinsic band and duplication 4 . Colonic atresia, torsion of a fallopian tube cyst, perforated duplications, foetus in fetu, cytomegalovirus, hepatitis A and Parvovirus B19 infection have been reported as rare causes of meconium peritonitis 5–7 . (Table 1) Nam et al.…”

Experience with meconium peritonitis

“…It was a very rare disease occurring in one per 30 000 live births [2][3][4]. Although many investigators have studied the pathogenesis of meconium peritonitis, it is not yet well understood [6,7].…”

“…The underlying causes of meconium peritonitis thus include meconium ileus, intestinal atresia, stenosis, internal hernia, neonatal Hirschsprung's disease, volvulus, intussusception, extrinsic band, and duplication [4,5,9]. Colonic atresia [10], torsion of a fallopian tube cyst [2], perforated duplications [11] and fetus-in-fetu [12] have been reported as rare causes of meconium peritonitis. In our study, intestinal atresia was the most common cause of meconium peritonitis.…”

“…Ultrasonography, however, is most widely used as a primary tool [2]. Ultrasonographic findings suggestive of meconium peritonitis are calcification, fetal ascites, hydramnios, pseudocyst, and dilated bowel.…”

“…This might result from improvements in prenatal diagnostic techniques and proper early management. Because the incidence of meconium peritonitis was very low, at 1 case in 30 000 births [2][3][4], many earlier reports were case reports but overview publications were rare. Here, we report our single-center experience of meconium peritonitis with a focus on the clinical outcome.…”