Meconium peritonitis and pseudo-cyst formation: prenatal diagnosis and post-natal course
Article first published online: 7 OCT 2003
Copyright © 2003 John Wiley & Sons, Ltd.
Volume 23, Issue 11, pages 904–908, November 2003
How to Cite
Eckoldt, F., Heling, K. S., Woderich, R., Kraft, S., Bollmann, R. and Mau, H. (2003), Meconium peritonitis and pseudo-cyst formation: prenatal diagnosis and post-natal course. Prenat. Diagn., 23: 904–908. doi: 10.1002/pd.720
- Issue published online: 7 OCT 2003
- Article first published online: 7 OCT 2003
- Manuscript Accepted: 21 JUL 2003
- Manuscript Revised: 8 JUL 2003
- Manuscript Received: 24 APR 2003
- meconium peritonitis;
- meconium pseudo-cyst;
- prenatal diagnosis;
- fetal ileus;
- bowel perforation
Intra-uterine bowel perforation can occur secondary to a variety of abnormalities and cause sterile peritonitis in the fetus (generalised = type I). If sealing of the perforation does not take place, a thick-walled pseudo-cyst can form (type II).
Over a 12-year period, 21 616 pregnancies were screened for gastro-intestinal malformations using prenatal ultrasound. We identified 1077 cases suspicious of surgically correctable malformations. Post-natal diagnoses and outcome were worked up retrospectively.
We found 96 fetuses with suspected gastro-intestinal malformations. Prenatal bowel perforation with meconium peritonitis was confirmed in 11 cases. In 5 of these 11, the correct diagnosis had been predicted prenatally. One child presented as a fetal and neonatal emergency (case report). Ten of the eleven infants were operated on during their first day of life. Intra-operative findings were atresia (n = 4), meconium ileus (n = 6) and no obvious cause (n = 1). Two children suffered fatal complications.
Meconium peritonitis and meconium pseudo-cysts as its special manifestation are assessable by prenatal diagnosis but present in different ways. They can present as fetal ascites or echogenic bowel and cause fetal or neonatal distress, requiring close observation and highly specialised care. Copyright © 2003 John Wiley & Sons, Ltd.