Presentation
However, this is also a late presentation when appendiceal perforation and peritonitis have occurred [11]. [karger.com]
Abstract A series of 99 cases of peritonitis due to bowel perforation occurring in infants less than 5 days of age is presented. [surgjournal.com]
Therefore, only the direct comparison results are presented. [cochranelibrary.com]
Meconium per vagina: a rare presentation of meconium peritonitis. J Pediatr Surg. 2008;43:e5–7. [bmcpediatr.biomedcentral.com]
Entire Body System
- Sepsis
However, the patient died on postoperative day 5 due to worsening sepsis and decompensated hemodynamic instability. [karger.com]
Peritonitis and Abdominal Sepsis. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/180234-overview. Accessed June 2012. Zieve, D. (2011 October 16). Ascites. MedlinePlus Medical Encyclopedia. [labtestsonline.it]
La peritonitis bacteriana espontánea activa podría impedir el trasplante hepático, ya que éste no se realiza durante el curso de una sepsis. [cochranelibrary.com]
- Trisomy 21
Our patient also had Down syndrome (trisomy 21), which was suspected on prenatal ultrasound and confirmed by genetic testing. Down syndrome was also reported as a condition associated with NA in one case report [9]. [karger.com]
Respiratoric
- Tachypnea
There was no tachypnea. Oxygen saturation was at 60–70% on 3 L of oxygen. The lung was clear to auscultation. The abdomen was distended without obvious tenderness or erythema. Bowel sounds were hypoactive. [karger.com]
- Respiratory Distress
distress (15%), abdominal mass (12%), and hematochezia (10%) [2]. [karger.com]
Gastrointestinal
- Acute Abdomen
Acute appendicitis is a rare diagnosis of acute abdomen in neonates which is associated with high mortality due to late diagnosis. [karger.com]
- Hematochezia
[…] nonspecific, including abdominal distention (75%), vomiting (42%), decreased oral intake (40%), sepsis (38%), temperature instability (33%), lethargy or irritability (24%), abdominal wall cellulitis (24%), respiratory distress (15%), abdominal mass (12%), and hematochezia [karger.com]
- Abdominal Mass
[…] wall cellulitis (24%), respiratory distress (15%), abdominal mass (12%), and hematochezia (10%) [2]. [karger.com]
Liver, Gall & Pancreas
- Jaundice
Initial blood test showed normal complete blood count, unconjugated hyperbilirubinemia in accordance with physiologic jaundice, mildly elevated C-reactive protein of 10.0 mg/L, normal renal function test, and mild electrolyte disturbance. [karger.com]
Article Google Scholar Sakai K, Ono S, Fumino S, et al. (2010) Clinical course of obstructive jaundice associated with operated meconium peritonitis in neonates. Eur J Pediatr Surg. 2010;20:222–5. [bmcpediatr.biomedcentral.com]
Skin
- Erythema
There was generalized tenderness and erythema of the abdomen on examination (Fig. 2). No blood was found on per rectal examination. A repeat abdominal ultrasound was made and revealed pneumoperitoneum and moderate ascites. [karger.com]
Psychiatrical
- Suggestibility
Others suggest that impaired vascular supply to the appendix can lead to perforation in conditions such as cardiac anomalies or other low-flow or hypoxic states. [karger.com]
In our cohort, the GA and BW of patients were higher in group A than in group B, suggesting that the general condition of group A patients was better. [bmcpediatr.biomedcentral.com]
We followed the approach suggested by Yepes‐Nunez and colleagues (Yepes‐Nunez 2019). [cochranelibrary.com]
Urogenital
- Cesarean Section
Case Report A 3,000-g boy was born by Cesarean section at 38+4 weeks of gestation to a 35-year-old mother. The patient had been diagnosed by prenatal ultrasound at 5 months of gestation with Down syndrome and PA-VSD. [karger.com]
Among all the patients, 49 were delivered via cesarean section, and 29 were vaginally delivered (one abandoned baby was not included due to the absence of a recorded delivery mode). [bmcpediatr.biomedcentral.com]
Neurologic
- Irritability
One of the reasons is that the presenting signs and symptoms of NA are nonspecific, including abdominal distention (75%), vomiting (42%), decreased oral intake (40%), sepsis (38%), temperature instability (33%), lethargy or irritability (24%), abdominal [karger.com]
Research by Raslau D et al. [18] showed that low birth weight infants have an increased likelihood to have irritable bowel syndrome. [bmcpediatr.biomedcentral.com]
- Lethargy
One of the reasons is that the presenting signs and symptoms of NA are nonspecific, including abdominal distention (75%), vomiting (42%), decreased oral intake (40%), sepsis (38%), temperature instability (33%), lethargy or irritability (24%), abdominal [karger.com]
Workup
X-Ray
- Pneumoperitoneum
On the seventh day pneumoperitoneum was diagnosed, emergency surgery was performed revealing perforation of Meckel's diverticulum. Perinatal asphyxia and indomethacin administration probably played an important role in this process. [actamedicaportuguesa.com]
A repeat abdominal ultrasound was made and revealed pneumoperitoneum and moderate ascites. The bowel loops were distended up to 28 mm. No portal venous gas or pneumatosis intestinalis was detected. [karger.com]
Laboratory
- Leukocytosis
A repeat blood test showed a leukocytosis of 11,780/µL with 68.1% neutrophils. C-reactive protein was markedly elevated at 224.3 mg/L. [karger.com]
Treatment
The roles of obstruction, site of perforation, type of peritonitis, delay in operative treatment, type of repair performed, and the coexistence of fibrocystic disease are tabulated. [surgjournal.com]
These trials compared four treatments. [cochranelibrary.com]
Four families discontinued the treatments due to multimalformation of the child and financial problems. [bmcpediatr.biomedcentral.com]
[Meconium peritonitis: diagnosis, etiology and treatment]. Govaert P, van Hecke R, Vanhaesebrouck P, Verpaele A, Derom F, Defoort P. Govaert P, et al. Tijdschr Kindergeneeskd. 1991 Jun;59(3):98-105. Tijdschr Kindergeneeskd. 1991. [pubmed.ncbi.nlm.nih.gov]
Neonatal surgery; early treatment of congenital malformations. Lancet. 1952 Feb 16;1(6703):332–339. [PubMed] [Google Scholar] ROSZA S, GROSS RJ. Intrauterine perforation of Meckel's diverticulum. [ncbi.nlm.nih.gov]
Prognosis
Shyu M et al. [8] demonstrated that the prognosis of MP patients with ileus can be improved by early operation. [bmcpediatr.biomedcentral.com]
Etiology
Ulcerative-necrotizing enterocolitis and mechanical causes represented the two main etiologies, each representing 44.44% of cases. [ejmed.org]
[Meconium peritonitis: diagnosis, etiology and treatment]. Govaert P, van Hecke R, Vanhaesebrouck P, Verpaele A, Derom F, Defoort P. Govaert P, et al. Tijdschr Kindergeneeskd. 1991 Jun;59(3):98-105. Tijdschr Kindergeneeskd. 1991. [pubmed.ncbi.nlm.nih.gov]
The etiology of NA also remains to be elucidated. There are, however, three different hypotheses in the literature. Some authors argued that NA is a localized form of NEC [7]. [karger.com]
Prevention
Mechanical etiologies which represent 44% of cases could have been prevented by early management of the causal pathologies. Meyer CL, Payne NR, Roback SA. [ejmed.org]
Additionally, the formation of pseudocysts can restrict the leakage of meconium and prevent infection spread. [bmcpediatr.biomedcentral.com]
Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis Antibiotic prophylaxis to prevent spontaneous bacterial peritonitis in people with liver cirrhosis Patient or population: people with liver cirrhosis Settings [cochranelibrary.com]