MECONIUM PERITONITIS

Meconium peritonitis is a sterile inflammatory reaction of the peritoneum due to bowel perforation in utero. Any cause of bowel obstruction may result in meconium peritonitis. Depending on the cause of the perforation, the peritonitis and ascites may resolve in utero or persist post-natally.

Bowel obstruction and perforation secondary to:

• Bowel atresia.
• Volvulus.
• Intussusception.
• Bands.
• Meckel's diverticulum.
• Incarcerated inguinal hernia.
• Meconium ileus.
• 40% of fetuses with cystic fibrosis will have meconium ileus.
• 10-15% of fetuses with cystic fibrosis will have meconium ileus and peritonitis.

PATHOGENESIS

ULTRASOUND

Link to Ultrasound

DIFFERENTIAL DIAGNOSIS

1. Congenital infection (toxoplasmosis or cytomegalovirus).
2. Meconium pseudocyst must be differentiated from other intra-abdominal cysts (mesenteric, omental urachal, ovarian), hydrometrocolpos and rarely congenital cystic intra-abdominal tumors.