腸管重複症による胎便性腹膜炎の１例

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  • Meconium Peritonitis Caused by Intestinal Duplication-induced Ileal Volvulus. Report of a case.

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This paper deals with a female infant with meconium peritonitis caused by intestinal duplication-induced ileal volvulus. At 35 weeks gestation, the patient was detected to have an intra-abdominal cystic mass by an ultrasonography. At 37 weeks gestation, massive ascites was detected, and she was delivered by a cesarean section. At the birth, her abdomen was severely distended. Because paracentesis revealed meconium-colored ascites and the abdominal distension was aggravated, an emergency operation was performed with a diagnosis of meconium peritonitis on the same day. The abdominal cavity was full of turbid ascites and meconium. Ileal volvulus, which seemed necrotic, was observed. In addition, there was a 2.5cm cystic tumor in the mesentery of the necrotic ileum. A localized perforation was observed 3cm to the oral side of the cyst. The necrotic ileum including the duplication cyst was excised. An end-to-end anastomosis was performed. Pathologic examination showed duplication of the ileum, which was lined with necrotic mucosa. No communication to the ileal lumen was found. Her subsequent postoperative course was uncomplicated. She was discharged from the hospital at 24 days of age. To our knowledge, no report has been published describing meconium peritonitis caused by intestinal duplication-induced ileal volvulus.

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