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Meconium peritonitis in Nigerian children.
A M Abubakar1, M A Odelola, C O Bode
1Paediatric Surgery Unit, Department of Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria. walo1ng@yahoo.co.uk
Annals of African Medicine
|July 24, 2009
Summary
Meconium peritonitis is a rare, often fatal neonatal condition. Intestinal obstruction is the most common cause, and early diagnosis and treatment are crucial for improving survival rates in Nigeria.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Abdominal surgery
Background:
- Meconium peritonitis is a rare neonatal condition with high mortality.
- Case reports in Nigeria and Africa are infrequent, highlighting a need for more data.
- Despite antenatal care and ultrasonography, diagnosis was missed in several cases.
Purpose of the Study:
- To investigate the incidence, clinical presentation, management, and outcomes of meconium peritonitis in Nigerian neonates.
- To identify the common causes and surgical approaches for meconium peritonitis.
- To emphasize the importance of early diagnosis and appropriate management to improve survival.
Main Methods:
- A 10-year retrospective study was conducted across three major Nigerian teaching hospitals and one federal medical center.
- Data were collected on all neonates diagnosed and treated for meconium peritonitis.
- Patient demographics, clinical findings, diagnostic imaging, surgical procedures, and outcomes were analyzed.
Main Results:
- Ten neonates (6 girls, 4 boys) were identified, with a median age of 4 days at presentation.
- Abdominal distension was the most common symptom (9/10).
- Intestinal obstruction was the leading cause (7/10), with ileum and jejunum being the most frequent perforation sites. Mortality rate was 50%.
Conclusions:
- Meconium peritonitis is rare in Nigeria, often associated with intestinal obstruction.
- Rectal biopsy is recommended for unidentifiable causes to rule out Hirschsprung's disease.
- Improved survival hinges on early diagnosis, appropriate surgical intervention, and meticulous postoperative care.
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