Image of the Month: Meconium Peritonitis with Pseudocyst—A Spot Diagnosis in Newborns

Abstract

We report on a male preterm newborn with a large abdominal tumor found on prenatal ultrasound 2 weeks prior to delivery at 36 + 0 weeks of gestation. A postnatal abdominal plain film showed a mass with well-defined rim calcifications (“eggshell”), suggestive of a meconium pseudocyst. On the 4th day of life, the boy underwent exploratory laparotomy with resection of the cyst and end-to-back jejunojejunostomy. The postoperative course was uneventful. A meconium pseudocyst is the correlate of a sterile peritonitis caused by antenatal bowel perforation. It is an easily recognizable spot diagnosis any pediatrician and pediatric surgeon should be aware of.

Keywords

meconium - pseudocyst - cyst - newborn - calcification

• References

• 1 Lee YC, Chen CJ. Meconium pseudocyst: a classical and successfully treated case. J Formos Med Assoc 2009; 108 (03) 247-252
• 2 Minato M, Okada T, Miyagi H. , et al. Meconium pseudocyst with particular pathologic findings: a case report and review of the literature. J Pediatr Surg 2012; 47 (04) e9-e12
• 3 Miyake H, Urushihara N, Fukumoto K. , et al. Primary anastomosis for meconium peritonitis: first choice of treatment. J Pediatr Surg 2011; 46 (12) 2327-2331
• 4 Chan KWE, Lee KH, Wong HYV. , et al. Cystic meconium peritonitis with jejunoileal atresia: is it associated with unfavorable outcome?. World J Clin Pediatr 2017; 6 (01) 40-44
• 5 Reynolds E, Douglass B, Bleacher J. Meconium peritonitis. J Perinatol 2000; 20 (03) 193-195
• 6 Sathe M, Houwen R. Meconium ileus in cystic fibrosis. J Cyst Fibros 2017; 16 (Suppl. 02) S32-S39