Prenatal diagnosis and conservative management of complex meconium peritonitis: a case report

Meconium peritonitis is a rare fetal disease due to the perforation of bowel in utero and sterile inflammatory reaction related to the extravasation of the meconium. Various classification systems have been published in the literature, and better outcomes have been seen in recent years with a survival rate of more than 90%. The prognosis of meconium peritonitis is more favorable when detected in utero rather than when the neonatal diagnosis is made.

Prenatal findings of meconium peritonitis in our case are meconium pseudocyst, polyhydramnios, and peritoneal calcifications. Although it was perceived as complex meconium peritonitis and was expected to require surgery in the postnatal period, it was managed conservatively. Probably, it did not need to undergo surgery because the perforation had occurred in mid-trimester and enough time has elapsed in the utero life to seal the perforation site and to decrease the size of the meconium pseudocyst. We cited a rare case of meconium peritonitis with a meconium pseudocyst in a fetus, which was managed conservatively and resolved spontaneously in the postnatal period.