Scrotal meconium pseudocysts: meconium periorchitis as a rare cause of postnatal acute scrotum

A 10-day-old newborn was taken to the paediatric emergency room due to scrotal swelling. Physical examination showed scrotal enlargement and palpable intrascrotal hard formations. Laboratory blood tests revealed no significant alterations. Testicular ultrasonography showed thickened and hypoechoic scrotal walls and bilateral intrascrotal isoechoic nodules with small internal calcifications. An abdominal X-ray confirmed evidence of bilateral scrotal microcalcifications and small calcifications in the left hypochondrium. Urgent laparotomy performed for scrotal exploration verified the presence of nodular formations on the vaginal tunic of both testicles; the nodules were removed. Bilateral orchidopexy was performed in the same surgical session. When dealing with an acute scrotum in a newborn both emergency radiologists and clinicians should consider the possibility of scrotal meconium pseudocyst as a rare but possible cause of periorchitis.

Image of the Month: Meconium Peritonitis with Pseudocyst—A Spot Diagnosis in Newborns

We report on a male preterm newborn with a large abdominal tumor found on prenatal ultrasound 2 weeks prior to delivery at 36 + 0 weeks of gestation. A postnatal abdominal plain film showed a mass with well-defined rim calcifications (“eggshell”), suggestive of a meconium pseudocyst. On the 4th day of life, the boy underwent exploratory laparotomy with resection of the cyst and end-to-back jejunojejunostomy. The postoperative course was uneventful. A meconium pseudocyst is the correlate of a sterile peritonitis caused by antenatal bowel perforation. It is an easily recognizable spot diagnosis any pediatrician and pediatric surgeon should be aware of.

A Triplication of 6q24 and Meconium Pseudocyst: A Case Report

With the rise in genetic screening both pre- and postnatally, new variances in genes are being recognized. Some are of unknown significance, while other known genetic expressions have obvious phenotypical expressions. Transient neonatal diabetes mellitus is a result of the duplication of chromosome 6q24, but little is known about the phenotypic expression of a triplication of chromosome 6q24. This case study presents an infant with a postnatally diagnosed triplication of chromosome 6q24, meconium pseudocyst, and multiple congenital anomalies with unknown genetic significance.

Meconium pseudocyst revisited

Meconium peritonitis is defined as a sterile chemical or foreign-body peritonitis that is caused by escape of meconium from the intestinal tract into the peritoneal cavity during the fetal or perinatal period. Although meconium peritonitis is indicative of intrauterine perforation of the intestine, it may occur as early as the 4th to 6th month of INTRA NATAL life and as late as several hours after birth. It can be classified into three pathological variations: fibro-adhesive; cystic and generalized. The cystic type has a meconium filled pseudocyst that may rupture in the peritoneal cavity. Intra-abdominal calcification is pathognomonic for the diagnosis. Here, author reported a classical case of meconium peritonitis with pseudocyst formation, which was treated successfully conservatively.

A Rare Association of Small Bowel Atresia and In-Utero Midgut Volvulus Presenting as Fetal Meconium Pseudocyst

Fetal meconium peritonitis (MP) is a rare occurrence. Neonate that survives this rare condition is likely to form a meconium pseudocyst. Hereby, we present a case of a 33-year-old pregnant woman that presented with premature rupture of membranes at 34 weeks of gestation. Antenatal ultrasonography at 33 weeks revealed abnormal dilated bowel within the viable fetus. An emergency Cesarean section was performed and a baby boy was delivered at 34 weeks. Physical examination of the baby at birth revealed a palpable central abdominal mass. Lower gastrointestinal contrast imaging revealed a non-opacified dilated proximal small bowel and opacified collapsed distal small bowels and colon. A laparotomy was carried out and revealed MP with pseudocyst formation due to a midgut volvulus. Interestingly, meconium contamination was confined due to associated atretic small bowel which occurred secondary to the volvulus.

Meconium Pseudocyst presented as Large Scrotal Swelling

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