Meconium thorax: a case report and review of literature

Area of Science:

• Medical imaging and diagnostics
• Fetal surgery and intervention
• Neonatal care

Background:

• Meconium peritonitis is a rare condition in neonates, often associated with bowel obstruction.
• Diaphragmatic defects can lead to herniation of abdominal contents into the chest.
• Intrathoracic calcifications can be a sign of fetal infection or inflammation.

Observation:

• A fetus diagnosed with meconium peritonitis at 23 weeks gestation presented with intrathoracic calcifications.
• Sonographic evaluation revealed three diaphragmatic defects, including two foramina of Morgagni and one large posterior defect.
• Additional muscular defects were noted in the rectus abdominus and bilateral loins.

Findings:

• The case highlights the extension of meconium peritonitis through diaphragmatic and abdominal wall defects.
• Despite fetal ascites and intraperitoneal meconium, the infant had an uneventful postoperative recovery.
• The infant showed normal chromosomes, no cystic fibrosis, and no significant dysmorphic features.

Implications:

• This case demonstrates the potential for fetal surgical intervention in complex cases of meconium peritonitis with diaphragmatic defects.
• Early diagnosis via sonography is crucial for timely management and improved outcomes.
• Long-term follow-up is important to monitor for developmental milestones and potential complications.