Report of 2 cases of meconium peritonitis

Oh, K K; Lee, D H; Choi, B S

Abstract

The author report 2 cases of mecoium periotonitis; one has 2 sites of perforation at terminal ileum withoutevidence of intestinal obstruction. The other was not proven the definite cause because of preoperative dead. Thefirst case was dead postoperavely even though successful Mikulicz exteriorization was done. Mechanism of meconiumperitonitis had been described by Morgani in 1761, but mechanism were by meconium reaches the peritoneal cavity issomething of a mystery. Usually rupture of intestinal wll may occure in association with obstruction ( manycongenital malforamtion and meconium ileus), but has been shown that a hole may occure in the absence ofobstruction. In our case 1, postmortem examination and surgical findings demonstrate the 2 perforation sites at5,10cm respectively from the ileocecal valve at terminal ileum with meconium ileus. A complete explanation forthis observation is lacking, however author postulate that intestine may perforate as a results of vigorousperistalsis in fetus with meconium ileus, that pass the meconium into the peritoneal cavity with relieve theobstruction. Two of our cases have scattered peritoneal wall calcification at birth. Author report the two casesof rare meconim peritonitis to insists the early radiologic evaluation make the better survivals.