Meconium pseudocyst associated with congenital CMV infection

Sucari Vlok,Vicci Du Plessis

doi:10.4102/sajr.v19i2.893

Sucari Vlok, Vicci Du Plessis

Open Access

https://doi.org/10.4102/sajr.v19i2.893

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Abstract

Meconium pseudocyst is a rare complication of fetal bowel perforation in utero, following extravasation and localised containment of meconium within the intra-peritoneal cavity.

Highlights

Meconium pseudocyst is a rare, perinatal complication of intra-uterine fetal bowel perforation, with very few cases reported in the literature
Meconium peritonitis may result in fixation of the inflamed bowel loops, forming a contained collection with a membranous wall, into which meconium may leak continuously from the perforation site.[1,2,3,4,5]
A relatively strong association with cystic fibrosis is seen in between 8% – 40% of patients diagnosed with meconium peritonitis, in which meconium ileus with subsequent perforation is the most likely cause.[1,2,4]

Summary

Introduction

Meconium pseudocyst is a rare, perinatal complication of intra-uterine fetal bowel perforation, with very few cases reported in the literature. The presence of a meconium pseudocyst indicates complex peritonitis which necessitates specialist evaluation, delivery at a tertiary care facility and, in most cases, neonatal surgical intervention.[2]. A 25-year-old HIV-positive pregnant woman (G3P2) was referred for antenatal ultrasound (US) at 28 weeks, which revealed a large, cystic intra-abdominal mass within the fetus, with an irregularly calcified rim and internal echoes (Figure 1). A computed tomography (CT) scan performed on the day of birth revealed a large, cystic intraabdominal mass with a calcified rim, displacing adjacent abdominal organs (Figure 2). Subsequent laparotomy was performed with extensive adhesiolysis to free the bowel, and biopsies obtained for histological evaluation, which confirmed meconium pseudocyst.

Discussion

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Conclusion