Meconium peritonitis
Overview
Meconium peritonitis refers to rupture of the bowel prior to birth, resulting in fetal stool (meconium) escaping into the surrounding space (peritoneum) leading to inflammation (peritonitis). Despite the bowel rupture, many infants born after meconium peritonitis in utero have normal bowels and have no further issues. Twenty percent of infants born with meconium peritonitis will have vomiting and dilated bowels on x-rays which necessitates surgery. Meconium peritonitis is often diagnosed on prenatal ultrasound where it appears as calcifications within the peritoneum. Infants with cystic fibrosis are at increased risk for meconium peritonitis. Meconium peritonitis was first described in 1838 by Carl von Rokitansky.
Imaging Findings
- Amorphous and irregular or curvilinear abdominal calcifications, with the latter suggesting cystic loculation or coating of the peritoneum (i.e. pseudocyst)
- Negative is mecomium does not calcify.
- Eventually, most of the calcification in meconium peritonitis slowly disappears.
Patient #1: Abdominal calcifications seen on prenatal ultrasound
Patient #2
References
Dirkes K, Crombleholme TM, Craigo SD, Latchaw LA, Jacir NN, Harris BH, D'Alton ME. The natural history of meconium peritonitis diagnosed in utero. J Pediatr Surg. 1995 Jul;30(7):979-82. PMID 7472957