Prathana Saskia, Amadeus Verrell Christopher, Iskandar Kristy, Anggraini Alifah
Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.
Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/UGM Academic Hospital, Yogyakarta 55291, Indonesia.
Heliyon. 2023 Jan 15;9(1):e12960. doi: 10.1016/j.heliyon.2023.e12960. eCollection 2023 Jan.
Giant cystic meconium peritonitis (MP) is a relatively rare entity. Prompt surgical treatment is required to manage the underlying etiology and reestablish the continuity of the intestines. Despite perinatal and postoperative care improvements, the overall mortality rate is still relatively high. We reported a giant cystic MP that was recognized using antenatal sonography (US). It was successfully treated with primary anastomosis.
We presented a female newborn with a chief complaint of abdominal mass. The prenatal sonography showed an intraabdominal cyst at the 28th week of gestation. She was born at the gestational age of 38 weeks via vaginal delivery from a primigravid mother without complications, with a birth weight of 3275 g. Elective surgery was performed at the age of eight days, and a calcified 10 cm cyst was revealed along with severe adhesions. The cyst was found to communicate with the ileum located 30 cm proximal from the ileocecal junction. No malrotation and volvulus were found. The cyst and a portion of the ileum were resected, followed by a primary end-to-end anastomosis. Pathologic examination showed necrotic tissue lined with epithelial tissue with microcalcifications containing bilirubin pigments, consistent with cystic MP. The patient has uneventfully discharged on postoperative day 17. The patient has normal growth and development, except for delayed walking, at the last follow-up of two years of age.
Giant cystic MP is a rare disorder that can be detected early using the antenatal US. Our case highlights the importance of early diagnosis for giant cystic MP using the antenatal US leads to prompt surgical treatment and a more favorable prognosis.
巨大囊性胎粪性腹膜炎（MP）是一种相对罕见的病症。需要及时进行手术治疗以处理潜在病因并重建肠道的连续性。尽管围产期和术后护理有所改善，但总体死亡率仍然相对较高。我们报告了一例通过产前超声（US）诊断出的巨大囊性MP。该病例通过一期吻合术成功治愈。
我们接诊了一名以腹部肿块为主诉的女婴。产前超声显示在妊娠28周时腹腔内有一个囊肿。她在孕38周时经阴道顺产出生，母亲为初产妇，无并发症，出生体重3275克。在出生八天时进行了择期手术，术中发现一个10厘米的钙化囊肿以及严重粘连。发现该囊肿与距回盲部近端30厘米处的回肠相通。未发现肠旋转不良和肠扭转。切除囊肿及部分回肠，随后进行一期端端吻合。病理检查显示坏死组织内衬上皮组织，有含胆红素色素的微钙化，符合囊性MP。患者于术后第17天顺利出院。在两岁的最后一次随访中，除走路延迟外，患者生长发育正常。
巨大囊性MP是一种罕见疾病，可通过产前超声早期检测到。我们的病例强调了使用产前超声对巨大囊性MP进行早期诊断的重要性，这可促使及时进行手术治疗并获得更有利的预后。
