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

Jih Huei Tan, Henry Chor Lip Tan, Zi Qin Ng, Najua Ramli, V Muthualhagi A/P Vellusamy

Abstract


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.


Keywords


Meconium peritonitis; Pseudocyst; Midgut volvulus

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DOI: http://dx.doi.org/10.21699/jns.v7i4.809

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Copyright (c) 2018 Jih Huei Tan, Henry Chor Lip Tan, Zi Qin Ng, Najua Ramli, V Muthualhagi A/P Vellusamy

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