clinical manifestations in infants with symptomatic meconium peritonitis

Clicks: 186
ID: 161685
2009
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Abstract
Meconium peritonitis (MP) develops when bowel perforation occurs in utero or soon after birth, resulting in leakage of meconium into the peritoneal cavity. The clinical features are often variable and prenatal ultrasonography plays an important role in prenatal diagnosis. Methods: We conducted a retrospective review of neonates diagnosed with MP in our hospital from January 1998 to December 2007. Prenatal examinations, postnatal presentations, investigations, management, patient outcomes, and possible causes were analyzed. Results: Ten patients (five boys, five girls) diagnosed with MP were studied. The most common prenatal ultrasonographic finding was fetal ascites (7/10, 70%), followed by polyhydramnios (3/10, 30%), bowel dilatation (3/10, 30%), intra-abdominal calcification (1/10, 10%), and hydrops fetalis (1/10, 10%). Two of our patients were completely normal on prenatal ultrasonography. Only one MP diagnosis (1/10, 10%) was definitely confirmed by prenatal ultrasonography due to the presence of ascites, bowel perforation and intra-abdominal calcification. Nine patients (90%) required surgical intervention because of bowel perforation (5), bowel atresia (2), obstruction due to ileus (1), and intussusception (1). Peritonitis was of cystic type in one case (10%), fibroadhesive in five cases (50%), and generalized in four cases (40%). All 10 patients survived without long-term gastrointestinal complications. Conclusion: Prenatal ultrasonography can be diagnostic for MP, which should be con sidered in the differential diagnosis of patients presenting with ascites or ab dominal distension at birth. Close observation of postnatal clinical manifestations and timely surgical intervention resulted in a high survival rate and favorable outcome in these patients at our hospital.
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tsai2009pediatricsclinical Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;Ming-Horng Tsai;Shih-Ming Chu;Reyin Lien;Hsuan-Rong Huang;Chih-Cheng Luo
Journal regulatory toxicology and pharmacology : rtp
Year 2009
DOI
10.1016/S1875-9572(09)60034-6
URL
http://www.sciencedirect.com/science/article/pii/S1875957209600346
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