Meconium pseudocyst presenting as massive ascites in a new-born

Area of Science:

• Neonatal surgery
• Pediatric surgery
• Gastrointestinal surgery

Background:

• Meconium pseudocyst (MPC) is a recognized surgical complication of prenatal bowel perforation.
• It typically presents in newborns, often requiring surgical intervention.

Observation:

• A unique case of MPC secondary to prenatal bowel perforation is presented.
• This case involved massive ascites necessitating peritoneal drainage for respiratory support.
• Notably, prenatal intra-abdominal calcifications were absent.

Findings:

• Massive ascites requiring peritoneal drainage is a previously unreported presentation of MPC.
• The disappearance of prenatal intraperitoneal calcifications has not been previously associated with MPC.
• Absence of prenatal calcifications does not exclude the diagnosis of MPC.

Implications:

• Neonatal care providers should consider MPC in cases of massive fetal ascites.
• Imaging findings, including the absence of calcifications, should not preclude MPC diagnosis.
• Early recognition and intervention are crucial for managing MPC and associated complications.