Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Meconium Peritonitis: A Rare Treatable Cause of Non-Immune Hydrops

  • Received : 2018.11.28
  • Accepted : 2019.02.26
  • Published : 2019.11.15
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Abstract

Meconium peritonitis as a cause of non-immune hydrops in neonates is rarely reported. Here we report such a rare occurrence. In our case, a routine antenatal scan at 25 weeks revealed isolated ascites. By 31 weeks of gestation, all features of hydrops were observed in scans. However, antenatal workup for immune and non-immune hydrops was negative. Subsequently, a preterm hydropic female baby was delivered at 32 weeks. She required intubation and ventilator support. An X-ray revealed calcification in the abdomen suggestive of meconium peritonitis. Ultrasound showed gross ascites, a giant cyst compressing the inferior vena cava, and minimal bilateral pleural effusion. Emergency laparotomy revealed meconium pellets and perforation of the ileum. Double-barrel ileostomy was performed, and the edema resolved and activity improved. The baby was discharged after 3 weeks. Ileostomy closure was done at follow-up. The baby is growing well.

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References

  1. Steurer MA, Peyvandi S, Baer RJ, MacKenzie T, Li BC, Norton ME, et al. Epidemiology of live born infants with nonimmune hydrops fetalis-insights from a population-based dataset. J Pediatr 2017;187:182-8.e3. https://doi.org/10.1016/j.jpeds.2017.04.025
  2. Patni B. Developmental assessment scales for Indian infants (DASII). Ind J Pract Pediatr 2012;14:409-12.
  3. Tsai MH, Chu SM, Lien R, Huan HR, Luo CC. Clinical manifestations in infants with symptomatic meconium peritonitis. Pediatr Neonatol 2009;50:59-64. https://doi.org/10.1016/S1875-9572(09)60034-6
  4. Kamata S, Nose K, Ishikawa S, Usui N, Sawai T, Kitayama Y, et al. Meconium peritonitis in utero. Pediatr Surg Int 2000;16:377-9. https://doi.org/10.1007/s003830000354
  5. Dillard JP, Edwards DK, Leopold GR. Meconium peritonitis masquerading as fetal hydrops. J Ultrasound Med 1987;6:49-51. https://doi.org/10.7863/jum.1987.6.1.49
  6. Mayock DE, Hickok DE, Guthrie RD. Cystic meconium peritonitis associated with hydrops fetalis. Am J Obstet Gynecol 1982;142(6 Pt 1):704-5. https://doi.org/10.1016/S0002-9378(16)32444-9
  7. Fukushima K, Morokuma S, Fujita Y, Tsukimori K, Satoh S, Ochiai M, et al. Short-term and long-term outcomes of 214 cases of non-immune hydrops fetalis. Early Hum Dev 2011;87:571-5. https://doi.org/10.1016/j.earlhumdev.2011.04.015
  8. Reynolds E, Douglass B, Bleacher J. Meconium peritonitis. J Perinatol 2000;20:193-5. https://doi.org/10.1038/sj.jp.7200287
  9. Wang CN, Chang SD, Chao AS, Wang TH, Tseng LH, Chang YL. Meconium peritonitis in utero---the value of prenatal diagnosis in determining neonatal outcome. Taiwan J Obstet Gynecol 2008;47:391-6. https://doi.org/10.1016/S1028-4559(09)60004-8