Abdulkadir Adekunle Y, Abdur-Rahman Lukman O
Department of Radiology, University of Ilorin Teaching Hospital, Ilorin, Kwara State Nigeria.
Cases J. 2009 May 14;2:7008. doi: 10.1186/1757-1626-2-7008.
Giant meconium cyst resulting from antenatal bowel perforation is rare and hardly reported in multiple gestations. We found only four documented cases in the electronic literature.
We report a giant meconium cyst in an 11-hour-old Nigerian boy of a discordant twin having ultrasonographic and plain radiographic diagnosis and surgical confirmation. Increasing abdominal girth from 35 cm to 41 cm within four hours of admission without ascites, pneumoperitneum and significant bowel distension make us assumed the meconium cyst to be "growing" in size. We reviewed the literature and proposed that where the fibrinous wall of meconium cyst allows for distensibility and the communication between the perforated bowel and meconium cyst persists, the meconium cyst acting as reservoir may continue to "grow" in size without remarkable intestinal distension probably, until the elastic limit is lost.
Meconium cyst can occur in twin pregnancy, grow to occupy the abdomen almost completely and may cause neonatal apnoea. The outcome is good post surgery.
产前肠穿孔导致的巨大胎粪囊肿罕见，在多胎妊娠中鲜有报道。我们在电子文献中仅发现4例有记录的病例。
我们报告一例巨大胎粪囊肿，患儿为一名11小时大的尼日利亚男婴，是双绒毛膜双胎中的不一致胎儿，经超声和X线平片诊断，并经手术证实。入院后4小时内腹围从35厘米增加到41厘米，无腹水、气腹及明显肠扩张，这使我们推测胎粪囊肿在“长大”。我们回顾文献并提出，若胎粪囊肿的纤维壁具有可扩张性且穿孔肠管与胎粪囊肿之间的通道持续存在，作为储存库的胎粪囊肿可能会继续“长大”，且可能不会出现明显的肠扩张，直到失去弹性限度。
胎粪囊肿可发生于双胎妊娠，可长大至几乎完全占据腹部，并可能导致新生儿呼吸暂停。手术效果良好。
