Meconium Peritonitis in an aseptic chemical peritonitis secondary to intestinal perforation between the fetal life and the early hours of postnatal life. Between January 1990 and June 1991, 15 cases of meconium peritonitis were studied
retrospectively
for the perinatal data, clinical features, radiologic findings, pathologic types, surgical findings and prognosis.
Out of the total of 15 patients there were 3 premature infants (20%). The total included 11 male and 4 female patient. The average birth weight was 3.29Kg(range : 2.6~4.2Kg). In 5 cases pregnancy had been complicated by polyhydramnios.
Approximately three-fourths of all patients presented with signs within 24 hours after birth, Signs of intestinal obstruction was predominated. The diagnosis could be made radiographically, in presence of intraabdominal and/or
scrotalcalcifications(5
cases), echogenic ascites(3 cases) or pneumoperitonium (2 cases).
Especially prenatal diagnosis could be made fetal sonogarphically in 4 cases(6.7%). Characteristic ultrasonogarphic findings included intraabdominal calcification(2 cases), fetal ascites(4 cases). echogenic ascites without calcification(2 cases).
Fibroadhesive type on pathologic classification was predominated (53.4%). Perforation sites were identified in 46.7% of the cases, mainly in the ileum, 5 patients (33.3%) had associated atresia of small intestine. Mortality was 40%(6/15), and
pseudocystic type had the worst prognosis. There was no case of cystic fibrosis.
We reviewed this series of 15 cases, along with the findings in 13 previously reproted cases in Korea. Out of the total of 28 patients, 15 (53.6%) were the fibroacdhesive, 6(21.4%) generalized, 5 (17.8%) pseudocystic, 2(7.2%) were the healed
type.
13
patents died and overall mortality was 46.4%. Our data suggests that early diagnosis, appropriate operation and perioperative intensive care will be necessary for the improvement of the prognosis of meconium peritonitis.
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