Fetal meconium peritonitis: case report

Abstract

Introduction: meconium peritonitis is a condition that is reported in 1 in 30.000 neonates, it presents with inflammation of the peritoneum, intestinal loops and mesenteries as a consequence of intestinal perforation secondary to underlying pathology such as intestinal atresia, meconium ileus, volvulus, among other causes. Case description: neonate at 38 weeks of gestation in whom meconium peritonitis is suspected by obstetric ultrasonography reporting polyhydramnios and dilated loops of the small intestine; A cesarean section was performed, and the newborn was found with ascites and abdominal distension. Exploratory laparotomy was performed less than 24 hours of age, and volvulus, thick intraluminal meconium and irreversible small intestine ischemia were reported. Segment resection and jejuno-ileal anastomosis, meconium evacuation and abdominal cavity lavage were performed. The neonate died after 21 days secondary to complications derived from the initial condition: pneumoperitoneum, multiple adhesions, and septic shock. Conclusion: the case mix of meconium peritonitis in this case report corresponds to other reports described in the literature by other authors; However, although it is a rare condition, it is serious, with survival rates now increasing more than 90% due to advances in prenatal diagnosis, surgical procedures, and neonatal intensive care. The authors recommend the use of obstetric or neonatal ultrasonography when meconium peritonitis is suspected of a timely surgical approach.