Intrauterine Intussusception Presenting as Fetal Ascites and Meconium Peritonitis

Khalilah Alhuda Binti Kamilen ◽  
Mohd Yusran Othman

Intussusception is a well-known cause of intestinal obstruction in children. Its occurrence in fetus as an intrauterine incidence is extremely rare and poses a diagnostic difficulty. Intrauterine intussusception may result in intestinal atresia once the gangrenous segment resorbed. However, a very late occurrence of intussusception just prior to delivery may present as meconium peritonitis. We are reporting a case of premature baby who was born at 35 weeks gestation via emergency caesarean for breech in labour. Routine scan 4 days prior to the delivery showed evidence of fetal ascites. She was born with good Apgar Score and weighed 2.5kg. Subsequently she developed respiratory distress syndrome requiring mechanical ventilation. She passed minimal meconium once after birth then developed progressive abdominal distension and vomiting. Abdominal radiograph on day 4 of life revealed gross pneumoperitoneum and bedside percutaneous drain was inserted to ease the ventilation. Upon exploratory laparotomy, a single ileal perforation was seen 20cm from ileocecal junction with an intussusceptum was seen in the distal bowel. Gross meconium contamination and bowel edema did not favour the option of primary anastomosis, thus stoma was created. Reversal of stoma was performed a month later and she recovered well. Fetus with a complicated intrauterine intussusception may present with fetal ascites and their postnatal clinical and radiological findings need to be carefully assessed for evidence of meconium peritonitis; in which a timely surgical intervention is required to prevent the sequelae of prolonged intraabdominal sepsis in this premature baby.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S18

2017 ◽  
Vol 06 (04) ◽  
Maciel JMW ◽  
Moritsugu CT ◽  
Alvares BR

2017 ◽  
Vol 8 (2) ◽  
pp. 15
Sirajuddin Soomro ◽  
Sikandar Ali Mughal ◽  
Fida Hussain Depar

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1991 ◽  
Vol 52 (9) ◽  
pp. 2115-2119
Toshinori FUJIHARA ◽  
Hidenori GOHRA ◽  
Sinji NOJIMA ◽  
Masaru MARUMOTO ◽  
Kensuke ESATO ◽  

2020 ◽  
Vol 2 (1) ◽  
pp. 13-15
Wilms MC ◽  
Lienert M

Background: Sigmoid volvulus in the neonate is an extremely rare condition needing emergency treatment. Sporadic cases of neonatal sigmoid volvulus and some in association with Hirschsprung’s disease have been documented. Sigmoid volvulus has been described only twice in the literature in association with anorectal malformation. However, newborns with anorectal malformations might be especially at risk for sigmoid volvulus due to increased intraluminal intestinal weight caused by bowel obstruction and its existence might be underreported. Case presentation: This is the case report of a full-term neonate with trisomy 21 who was diagnosed with anorectal malformation upon birth. An abdominal X-ray on his second day of life showed typical radiological findings of sigmoid volvulus as described by the radiologist. However, the findings were interpreted as a dilated rectosigmoid sling typical for anorectal malformation by the surgeon and a transverse loop colostomy was placed. On the fourth postoperative day sigmoid perforation occurred and led to meconium peritonitis and septic shock. An emergency laparotomy was performed and a perforation at the distal sigmoid colon was found. Conclusion: There is an urgent need to raise awareness as to the existence of sigmoid volvulus in the neonate with anorectal malformations. The distinct radiological findings of the “coffee bean sign”, the “northern exposure sign” and an empty rectum allow to distinguish the extremely rare sigmoid volvulus from the common finding of a dilated rectosigmoid in patients with anorectal malformations. Detorsion of sigmoid volvulus is vital to preventing sigmoid perforation.

2019 ◽  
Vol 6 (12) ◽  
pp. 4539
Sneha Hemachandran ◽  
Chaithanya J. ◽  
Anjala Kumar ◽  
Keshav Murthy ◽  
Girish M. L.

Meconium peritonitis is a non-bacterial, chemical inflammation of the peritoneum caused by antenatal or postnatal perforation of intestine by inspissated meconium. Surgery is necessary when signs of intestinal obstruction are present. The incidence of meconium peritonitis is about 1:30,000. Perinatal morbidity and mortality is about 80%. In the case of meconium peritonitis, the incidence of prematurity is 20-30 %. Author present an unusal case of meconium ileus with multiple ileal perforation leading to peritonitis.

2015 ◽  
Vol 1 (1) ◽  
pp. 43-45
Kamal Koirala ◽  
Mahesh Khakurel ◽  
Reeta Barai

Jejunal diverticula are rare and usually asymptomatic. Acute complications may include haemorrhage, diverticulitis, obstruction, abscess formation and perforation. Here we report a case of 61 years lady who presented with generalized abdominal pain, vomiting and fever. There were features of acute peritonitis on examination. Exploratory laparotomy revealed a perforated jejunal diverticulum. Resection of the jejunal segment containing the perforated diverticulum and primary anastomosis was done. Histopathological examination revealed jejunal diverticulum with pinhole perforation. DOI:   Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):43-45

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