Meconium Peritonitis: Missed Opportunities and Diagnostic Challenges

Maria Paula Alvarez Saenz, Delia Theurel Martin, Juan Pablo Otoya Castrillon, Crisar Guerrero Quiroz, Edwin Medina Medina, Jorge Luis Alvarado Socarras

Abstract

Meconium peritonitis causes conditions such as adynamic ileus, intestinal obstruction by flanges, and short bowel in neonates. The clinical spectrum of this state can vary from a mild condition that does not require surgical management to a severe state that results in high mortality rate despite surgical correction. A male neonate was born at 37 weeks of gestation to a 25-year-old woman in Fundacion Cardiovascular de Colombia (Santander, Colombia). The neonate clinically deteriorated at birth, with abdominal distension and changes in the color of the abdominal wall. The condition was postnatally diagnosed as meconium peritonitis. The condition required surgical treatment in 2 stages—intestinal resection and double-mouth ileostomy with subsequent terminal anastomosis. The neonate was examined thoroughly to find the cause for the meconium peritonitis that is secondary to mechanical, physiological, or infectious obstruction.