== Abstract ==

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Generalized Meconium Peritonitis Diagnosed with Antenatal Ultrasonography

Soong Chul Kim, M.D., Shin Hwang, M.D.,

Shi Joon Yoo, M.DI )., and In Koo Kim, M.D.

Department of Surgery and Radiology} University of Ulsan, College of Medicine

and Asan Medical Center Seoul, Korea

Meconium peritonitis is defined as an aseptic, chemical or foreign-body peritonitis caused by spill of meconium in the abdominal cavity related to the prenatal perfora­tion of the intestine. Perforation is usually caused by obstruction from meconium ile­us, intestinal atresia, stenosis, volvulus, internal hernia, congenital pertoneal bands, intussusception, or gastroschisis. Less commonly, no evidence of distal obstruction exists.

Here, we present two cases of generalized meconium peritonitis of antenatal diag­nosis.

The first case, detected at 8 months of gestational age, had a perforation of the proximal blind pouch of jejunal atresia, associated with respiratory distress due to severe abdominal distension. This case was successfullY treated with resection and anastomosis and brief period of postoperative ventilatory support.

The second case had a distal ileal perforation with thick meconium in the terminal ileum. In this case, there was no dilatation of ileum proximal to the perforation site. Resection and anastomosis was performed and postoperative course was uneventful.

Index Words: Meconium, Peritonitis, Antenatal diagnosis

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Fig. 1. Antenatal obstetric ultrasonography. case

2 : intraperitoneal . calcification and dilatated

proximal bowel.

Fig. 2. Postnatal plain abdominal film. case 2 : no

gas in small bowel. ascites and intraperi-toneal

calcification.

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