Abstract
Meconium peritonitis is defined as aseptic chemical inflammation caused by an intrauterine bowel perforation. Its incidence is 1 in 35,000 live births. We present a case of meconium peritonitis presented at second day of postnatal life with isolated gross fetal ascites. Exploratory laprotomy was performed, suggestive of gross ascites with fecal contamination and perforation at terminal ileum for which ileal resection with double barrel ileostomy had been done. Postoperatively patient condition had improved and discharged. We would like to highlight this rare presentation of meconium peritonitis following intrauterine bowel perforation in fetus.
Highlights
Meconium peritonitis is defined as aseptic chemical inflammation caused by an intrauterine bowel perforation
Prenatal ultrasound demonstrating foetal ascites, intra-abdominal calcifications, and dilated loops of bowel are most frequently associated with meconium peritonitis.[5]
The extrusion of meconium can appear as a solitary mass inside foetal ascites or as disseminated echogenic masses
Summary
Meconium peritonitis is defined as aseptic chemical inflammation caused by an intrauterine bowel perforation. A male baby born through spontaneous vaginal delivery by 27 yrs old G2P1L1 mother at 36 weeks of gestation with birth weight of 3 kg was referred to our centre at 26 hour of life for abdominal distension since birth. The operative finding was gross ascitis with fecal contamination, crumpled bowel loops with perforation at terminal ileum 20 cm proximal to illeocecal junction (Figure 3). With this intraoperative finding peritoneal lavage with adhesiolysis with resection of ileal segment with double barrel ileostomy was done and shifted to NICU. Baby was extubated and feeding again started at tenth day of life. On regular follow up baby was gaining weight, feeding well and neurologically normal
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