Meconium Peritonitis with Multiple Ileal Perforations in a Twin

Samuel Wabada

doi:10.47338/jns.v5.278

Abstract

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Highlights

The patient was a 6-hour-old boy, a first twin delivered at the federal medical centre Yola by a 20-year-old house wife per vaginum after 39 weeks of unsupervised pregnancy
The bowel proximal to the perforations was moderately dilated. This segment of the ileum was resected about 15cm from the ileocecal junction and an ileoileal endto-end anastomosis was performed
In utero intestinal perforation could be due to various causes and can lead to generalized, fibro-adhesive or cystic forms of meconium peritonitis [1]

Summary

Introduction

The patient was a 6-hour-old boy, a first twin delivered at the federal medical centre Yola by a 20-year-old house wife per vaginum after 39 weeks of unsupervised pregnancy. The patient was taken for exploratory laparotomy after resuscitation. The intraoperative findings were meconium ascites, three ileal perforations (Fig. 1) on the antimesenteric border, each not less than 2cms apart, and approximately 20cm from the ileocecal junction. There were fibrinous adhesions involving loops of the distal ileum. There was a bolus of large meconium distal to the perforations with collapsed loops of bowel distal to it.

Results

Conclusion