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Case Report
Meconium pseudocyst without radiological calcification
1 Consultant, Department of Paediatric Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad, West Indies
2 Registrar, Department of Paediatric Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad, West Indies
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Reshma Doodnath
Department of Paediatric Surgery, Eric Williams Medical Sciences Complex, Champs Fleurs, Mount Hope, Trinidad,
West Indies
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Article ID: 100016Z19RD2023
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Doodnath R, Dubay C, Khan R. Meconium pseudocyst without radiological calcification. J Case Rep Images Pediatr 2023;5(1):1–5.ABSTRACT
Introduction: Meconium peritonitis is a rare disease which can be potentially fatal.
Case Report: We present the history of a full-term male infant born at 2945 g via lower segment cesarean section (LSCS). There was an antenatal diagnosis of an intra-abdominal cyst. At 27+6 weeks gestation, the ultrasound scan noted a thick-walled cystic mass superior to the bladder. Postnatally, an X-ray showed a paucity of gas in the right lower quadrant and an ultrasound scan confirmed a large central avascular cystic lesion, with posterior sediments noted. Laparotomy revealed extensive adhesions surrounding a meconium filled cyst. This was excised and a primary anastomosis performed. However, he failed to progress with feeds, having intermittent abdominal distension, and after a contrast study on day 18 post op which showed failure of contrast to pass the dilated proximal jejunum, he was taken back to the operating room and was found to have significant adhesions. Adhesiolysis was done and the anastomosis was patent and well healed. However, these episodes of abdominal distension continued, and he never progressed with feeds. On day 39 of life, there was severe metabolic acidosis refractory to resuscitation, leading to cardiac arrest.
Conclusion: There can be subtle presentations of meconium peritonitis in the newborn and it should be considered in any neonate with an intra-abdominal cyst.
Keywords: Intra-abdominal calcification, Meconium peritonitis, Meconium pseudocyst, Neonatal surgery
SUPPORTING INFORMATION
Acknowledgments
Dr. Mala Geelal, Consultant Pathologist, Eric Williams Medical Sciences Complex, Champs Fleurs, Trinidad, West Indies.
Author ContributionsReshma Doodnath - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Cidi Dubay - Conception of the work, Design of the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Roger Khan - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2023 Reshma Doodnath et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
