Meconium Peritonitis in a Neonate: Clinical and Radiological Findings

Abstract

Although meconium peritonitis has a low incidence (1 in 35,000 births), when occurs with a late diagnosis it usually leads to a high morbidity and mortality of neonates. This anomaly takes place due to bowel perforation and the consequence is the meconium extravasation into the peritoneal cavity, promoting an exudative inflammatory reaction due to various gastrointestinal pathologies that occurs in neonates or intrauterine. It is worthwhile mentioning that this inflammatory response may result in ascites, fibrosis, and calcification and, in some cases, in cyst formation. Clinical manifestations are non-specific; some of them are: intestinal changes, decrease in the general condition or abdominal physical alterations. In this work, it is described the case of a premature neonate, in which, by physical examination, solid masses in the lower part of abdomen were identified, being afterwards submitted to a thoracic-abdominal x-ray examination. The condition suddenly progressed to sepsis, leading to patient´s death. Bearing all this in mind, this work reports the need of a reinforced standard radiographic image that could be used as a basis in similar cases, helping the diagnosis so that the best treatment strategy may be defined.