J Korean Soc Radiol.  2014 Feb;70(2):159-162. 10.3348/jksr.2014.70.2.159.

Diagnostic Usefulness of CT in Meconium Pseudocyst in a Newborn: A Case Report

• Park HG
• Kim KS
• Choi SY
• Yu IK

• KMID: 1839426
• DOI: http://doi.org/10.3348/jksr.2014.70.2.159

Abstract

A meconium pseudocyst is rare and may result in the death of the neonate. Meconium pseudocysts should be distinguished from the cystic-type meconium peritonitis because of their differences in the treatment strategy. Various studies have reported the radiographic and sonographic findings of a meconium peritonitis. However, computed tomography (CT) findings of meconium pseudocyst have been rarely reported yet. In this report we present the CT findings of a patient with a meconium pseudocyst. Such CT findings may help in the proper diagnosis and to distinguish the cystic-type meconium peritonitis from the meconium pseudocyst.

MeSH Terms

Diagnosis
Humans
Infant, Newborn*
Meconium*
Peritonitis
Ultrasonography

Figure

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  Fig. 1 Immediately after birth, the simple radiograph shows a soft tissue density mass in the mid-abdomen and egg-shell calcifications (arrows).

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  Fig. 2 Abdominal ultrasonography shows a well defined complicated cystic mass with echogenic walls separate from bowel.

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  Fig. 3 A newborn with distended abdomen. A. The non-enhanced axial CT scan reveals a cystic mass with diffuse wall calcification and adjacent mesenteric calcifications. B, C. The contrast-enhanced axial (B) and sagittal CT (C) scans show a nonenhanced cystic mass with wall calcification and communication (arrows) between the cyst and adjacent dilated bowel.

Reference

1. Minato M, Okada T, Miyagi H, Honda S, Takazawa K, Kubota KC, et al. Meconium pseudocyst with particular pathologic findings: a case report and review of the literature. J Pediatr Surg. 2012; 47:e9–e12.

2. Foster MA, Nyberg DA, Mahony BS, Mack LA, Marks WM, Raabe RD. Meconium peritonitis: prenatal sonographic findings and their clinical significance. Radiology. 1987; 165:661–665.

3. Lee YC, Chen CJ. Meconium pseudocyst: a classical and successfully treated case. J Formos Med Assoc. 2009; 108:247–252.

4. Shyu MK, Shih JC, Lee CN, Hwa HL, Chow SN, Hsieh FJ. Correlation of prenatal ultrasound and postnatal outcome in meconium peritonitis. Fetal Diagn Ther. 2003; 18:255–261.

5. Simmons N, Shaw NJ, Mann G, Ibrahim CP. Large calcified intra-abdominal mass in a newborn. Arch Dis Child Fetal Neonatal Ed. 2009; 94:F163.

6. McNamara A, Levine D. Intraabdominal fetal echogenic masses: a practical guide to diagnosis and management. Radiographics. 2005; 25:633–645.

7. Salman AB, Karaoğlanoğlu N, Suma S. Abdominal, scrotal, and thoracic calcifications owing to healed meconium peritonitis. J Pediatr Surg. 1999; 34:1415–1416.

8. Tanaka K, Hashizume K, Kawarasaki H, Iwanaka T, Tsuchida Y. Elective surgery for cystic meconium peritonitis: report of two cases. J Pediatr Surg. 1993; 28:960–961.

9. Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol. 2001; 176:289–296.