Meconium pseudocyst secondary to ileum volvulus perforation without peritoneal calcification: a case report

Abstract

IntroductionA case of giant meconium pseudocyst secondary to ileum volvulus perforation is presented. Conventional radiographic features of meconium peritonitis with secondary meconium pseudocyst formation are well described. Our case is unusual in comparison to other cases reported in the literature and needs to be reported because the meconium pseudocyst presented without the typical ultrasound features (calcifications, polyhydramnios and ascites) and was initially identified as an abdominal mass.Case presentationWe describe the case of a 29-year-old Caucasian woman in her third trimester of pregnancy, in which an abdominal mass was detected in the fetus. The newborn was diagnosed in the early neonatal period with meconium pseudocyst secondary to ileum volvulus perforation.ConclusionsThe prenatal appearance of a meconium pseudocyst can be complemented by other signs of bowel obstruction (if present) such as polyhydramnios and fetal bowel dilatation. This is an original case report of interest to all clinicians in the perinatology and fetal ultrasound field. We consider that the utility of this case is the recognition that a meconium pseudocyst might appear without the typical ultrasound features and should be considered as a differential diagnosis when an echogenic intra-abdominal cyst is seen.

Prenatal Diagnosis of the Acute Meconium Peritonitis Secondary to Ileum Volvulus Perforation: A Case Report

“…Possible causes of bowel perforation include mesenteric vascular insufficiency and bowel obstruction such as meconium ileus, intestinal atresia or stenosis, volvulus, intussusception, duplication, and extrinsic band [1]. Intestinal stenosis or atresia and meconium ileus account for 65% of the cases [2]. Dilated bowel loop and/or polyhydramnios are usually associated with bowel obstruction [1].…”

What is your diagnosis?

“…Other than meconium pseudocyst, possible diagnosis of abdominal cysts contains a wide range of diseases such as omental and mesenteric cysts, intestinal duplication cysts, obstructive uropathy, choledochal, pancreatic, urachal, renal and ovarian cysts, hydrometrocolpos, imperforate anus, Meckel diverticulum, ureterocele and sacrococygeal teratomas ( 1 ). Meconium ileus, volvulus, intestinal stenosis, atresia, intussusception and mesenteric vascular insufficiency could be a reason for intestinal perforation ( 2 ).…”

Does Meconium Peritonitis Pseudo-Cyst Obstruct Labour?

“…The prevalence of MP is about 0.29 per 10,000 live births; mortality ranges from 2.4% to 50%, and morbidity up to 34% [5, 6]. …”