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本月影像：伴有假性囊肿的胎粪性腹膜炎——新生儿的一个即时诊断病例

Image of the Month: Meconium Peritonitis with Pseudocyst-A Spot Diagnosis in Newborns.

作者信息

Ascherl Rudolph, Vaz Pimentel Duarte, Knüpfer Mathias, Sorge Ina, Lacher Martin, Zimmermann Peter

机构信息

Department of Neonatology, Universitätsklinikum Leipzig, Leipzig, Germany.

Department of Pediatric Surgery, Universitätsklinikum Leipzig, Leipzig, Germany.

出版信息

European J Pediatr Surg Rep. 2020 Jan;8(1):e1-e2. doi: 10.1055/s-0039-3399556. Epub 2020 Jan 28.

DOI:10.1055/s-0039-3399556
PMID:31998597
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6986892/
Abstract

We report on a male preterm newborn with a large abdominal tumor found on prenatal ultrasound 2 weeks prior to delivery at 36 + 0 weeks of gestation. A postnatal abdominal plain film showed a mass with well-defined rim calcifications ("eggshell"), suggestive of a meconium pseudocyst. On the 4th day of life, the boy underwent exploratory laparotomy with resection of the cyst and end-to-back jejunojejunostomy. The postoperative course was uneventful. A meconium pseudocyst is the correlate of a sterile peritonitis caused by antenatal bowel perforation. It is an easily recognizable spot diagnosis any pediatrician and pediatric surgeon should be aware of.

摘要

我们报告一例男性早产新生儿，在妊娠36 + 0周分娩前2周的产前超声检查中发现腹部有一个大肿瘤。产后腹部平片显示一个边缘有清晰蛋壳样钙化的肿块，提示为胎粪假性囊肿。出生后第4天，该男婴接受了剖腹探查术，切除囊肿并进行空肠端端吻合术。术后过程顺利。胎粪假性囊肿是产前肠穿孔引起的无菌性腹膜炎的相关病变。这是任何儿科医生和儿科外科医生都应知晓的一种易于识别的现场诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf9e/6986892/98780fce588d/10-1055-s-0039-3399556-i190503-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf9e/6986892/e5c220457a18/10-1055-s-0039-3399556-i190503-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf9e/6986892/98780fce588d/10-1055-s-0039-3399556-i190503-2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf9e/6986892/e5c220457a18/10-1055-s-0039-3399556-i190503-1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf9e/6986892/98780fce588d/10-1055-s-0039-3399556-i190503-2.jpg

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本文引用的文献

1
Meconium ileus in Cystic Fibrosis.先天性肠纤维化性肠梗阻。
J Cyst Fibros. 2017 Nov;16 Suppl 2:S32-S39. doi: 10.1016/j.jcf.2017.06.007.
2
Cystic meconium peritonitis with jejunoileal atresia: Is it associated with unfavorable outcome?伴有空回肠闭锁的胎粪性腹膜炎：它与不良预后有关吗？
World J Clin Pediatr. 2017 Feb 8;6(1):40-44. doi: 10.5409/wjcp.v6.i1.40.
3
Meconium pseudocyst with particular pathologic findings: a case report and review of the literature.有特殊病理表现的胎粪性假性囊肿：病例报告及文献复习。
J Pediatr Surg. 2012 Apr;47(4):e9-12. doi: 10.1016/j.jpedsurg.2011.11.050.
4
Primary anastomosis for meconium peritonitis: first choice of treatment.一期肠吻合术治疗胎粪性腹膜炎：首选治疗方案。
J Pediatr Surg. 2011 Dec;46(12):2327-31. doi: 10.1016/j.jpedsurg.2011.09.031.
5
Meconium pseudocyst: a classical and successfully treated case.胎粪假性囊肿：一例典型且成功治愈的病例。
J Formos Med Assoc. 2009 Mar;108(3):247-52. doi: 10.1016/S0929-6646(09)60059-0.
6
Meconium peritonitis.胎粪性腹膜炎
J Perinatol. 2000 Apr-May;20(3):193-5. doi: 10.1038/sj.jp.7200287.