Advertisement
Rapid Communication| Volume 47, ISSUE 4, e9-e12, April 2012

Meconium pseudocyst with particular pathologic findings: a case report and review of the literature

      Abstract

      Meconium peritonitis is a sterile chemical peritonitis caused by bowel perforation with intraperitoneal extravasation of the meconium in utero. When the inflamed intestinal loops become fixed, meconium peritonitis leads to a cystic cavity with a fibrous wall, and the result is termed cystic-type meconium peritonitis. On the contrary, a meconium pseudocyst has a muscle layer continuous with the normal intestine and is distinguished from cystic-type meconium peritonitis based on the histopathologic findings.
      This report describes the rare case of a neonate complicated by a meconium pseudocyst, which was successfully treated with 1-stage resection and primary anastomosis. There have been few cases of meconium pseudocysts reported in the literature. Meconium peritonitis should be considered in the differential diagnosis in patients who develop large abdominal cysts with air and fluid content.
      Cystic-type meconium peritonitis is usually treated using drainage with subsequent elective surgery. However, for a meconium pseudocyst, 1-stage intestinal resection with primary anastomosis may be recommended. A meconium pseudocyst may be treatable using 1-stage resection based on histopathologic features.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Pediatric Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • David D.
        Meconium pseudocyst.
        Pediatr Radiol. 2010; 40: S105
        • Esther V.
        • David R.
        • Antonio V.
        • et al.
        Meconium pseudocyst secondary to ileum volvulus perforation without peritoneal calcification: a case report.
        J Med Case Reports. 2010; 4: 292
        • Yao-Chou L.
        • Chau-Jing C.
        Meconium pseudocyst: a classical and successfully treated case.
        J Formos Med Assoc. 2009; 108: 247-257
        • Shawn D.L.
        • Andre H.
        Meconium pseudocyst in a newborn.
        J Am Coll Surg. 2006; 203: 399
        • Eckoldt F.
        • Heling K.S.
        • Woderich R.
        • et al.
        Meconium peritonitis and pseudo-cyst formation: prenatal diagnosis and post-natal course.
        Prenat Diagn. 2003; 23: 904-908
        • Fujioka M.
        Ileus and cyst formation: a case report of intra-abdominal cyst due to intestinal atresia and volvulus of the ileum.
        Jpn J Pediatr Surg. 1996; 28: 467-472
        • Lorimer W.S.
        • Dick G.E.
        Meconium peritonitis.
        Surgery. 1966; 60: 470-475
        • Vaclav S.
        • Jiri L.
        Meconium pseudocyst secondary to ileal atresia complicated by volvulus: antenatal MR demonstration.
        Pediatr Radiol. 2007; 37: 305-309
        • Alex M.W.
        • Cheng-Hong T.
        • Reyin L.
        • et al.
        Prenatal MR imaging of a meconium pseudocyst extending to the right subphrenic space with right lung compression.
        Pediatr Radiol. 2006; 36: 1208-1211
        • Tanaka K.
        • Hashizume K.
        • Kawasaki H.
        • et al.
        Elective surgery for cystic meconium peritonitis: report of two cases.
        J Pediatr Surg. 1993; 28: 960-961