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Meconium peritonitis-observations in 115 cases and antenatal diagnosis
Abstract:
In 20 years the authors have met with 115 cases of meconium peritonitis (MP). The high incidence in China is shown. In all cases there were intraabdominal calcifications. There were no cases of fibrocystic disease. The authors classify 3 types: 1. Neonatal obstructive type 41 cases. 2. Free perforation with: Free pneumoperitoneum 15 cases. Localized pneumoperitoneum 23 cases. 3. No signs or symptoms, with potential intestinal obstruction 23 cases. The series shows a low incidence of atresia. The authors suggest necrotizing enterocolitis as a cause because of the high incidence of stenosis. Three prenatally diagnosed cases are discussed. All had hydramnios and fetal abdominal calcifications. Two of these were confirmed after birth. The mortality is high (42.6%). Abdominal x-ray in all cases with polyhydramnios may lead to a positive diagnosis of MP.
Insights
Meconium peritonitis (MP) is a significant condition in China, with intraabdominal calcifications common in all cases. Necrotizing enterocolitis is a potential cause, and prenatal diagnosis is possible.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Fetal medicine
Background:
- Meconium peritonitis (MP) is a serious neonatal condition.
- A 20-year study reviewed 115 cases of MP in China.
- Intraabdominal calcifications were present in all cases.
Observation:
- The study classified MP into three types: neonatal obstructive, free perforation, and asymptomatic with potential obstruction.
- A low incidence of intestinal atresia was noted.
- Necrotizing enterocolitis was suggested as a cause due to high stenosis rates.
Findings:
- Three cases of prenatal diagnosis are discussed, all with hydramnios and fetal abdominal calcifications.
- Two prenatal cases were confirmed postnatally.
- The overall mortality rate for meconium peritonitis was high at 42.6%.
Implications:
- Abdominal X-rays in cases of polyhydramnios may aid in diagnosing MP.
- Understanding MP subtypes and causes is crucial for neonatal care.
- Further research into necrotizing enterocolitis as a cause of MP is warranted.