Meconium Peritonitis

Abstract

Meconium peritonitis (MP) is defined as aseptic, localized, or generalized peritonitis due to leakage of meconium into the peritoneal cavity due to perforation of the fetal intestine in utero. The incidence of MP is 1/30000. Even hypotheses related with ischemic events are most popular ones; neither of them has been substantiated yet. As first meconium reaches the ileum about 16th gestational week, timing of the event also determines the pathological types of MP, as fibro-adhesive, generalized, or cystic type. Intra-abdominal calcifications, being the most pathognomonic feature of the MP, are originated from the catalytic effect of fatty meconial compounds on the precipitation of calcium salts. A grading system described by Zangheri et al. can be used for international standardization of prenatal diagnosis. Antenatal diagnosis should also include investigation for congenital anatomical or structural anomalies, cystic fibrosis, and chromosomal abnormalities. When there is prenatal suspicion of MP in a patient, postnatal diagnosis is through abdominal and/or scrotal radiographs and ultrasonography. The natural history of prenatally diagnosed MP is different than diagnosed postnatally since some prenatally diagnosed cases resolve spontaneously. While there is not an established treatment modality in prenatal period, postnatal treatment varies depending on the signs and symptoms of the neonate.