Cystic meconium peritonitis: ultrasonographic features

Area of Science:

• Neonatal imaging
• Pediatric surgery
• Gastrointestinal pathology

Background:

• Meconium peritonitis is a rare condition resulting from fetal intestinal perforation.
• It can manifest as localized or generalized inflammation and adhesions.
• Encysted collections of meconium are a specific presentation.

Observation:

• Two neonates presented with cystic meconium peritonitis.
• Sonography revealed well-defined, echogenic abdominal masses.
• One mass demonstrated internal calcifications.

Findings:

• Cystic meconium peritonitis can present as large, localized meconium collections.
• The cyst wall is composed of fibrous granulation tissue.
• Presence of gas within the cyst suggests ongoing bowel perforation; absence suggests in utero sealing.
• Calcification is an inconsistent sonographic finding.

Implications:

• Early detection of cystic meconium peritonitis is crucial for timely surgical intervention.
• Prenatal sonography can identify these masses, aiding in planning delivery and management.
• Understanding cyst characteristics (gas, calcification) can inform prognosis and surgical approach.