A Case Report of Meconium Ileus-Peritonitis with a Prenatal Diagnosis of Sacro-Coccygeal Teratoma

Baflak Baksu, ‹nci Davas, Jale Özgül, Figen Ezen, Alper Özel, Gülden Yenice, Mehmet Yalç›n
2005 Perinatal Journal •   unpublished
Backround: To discuss the diffuculties in the diagnosis of meconium peritonitis and to determine the role of magnetic resonance in differential diagnosis. Case: Twentyfour-year-old woman with a 33-gestational-weeks pregnancy was hospitalized due to polyhydramnios and a fetal pelvic semi-solid mass with areas of calcifications, measuring 66x55 mm in diameter, showing no vascularization that was diagnosed by obstetric ultrasonography, magnetic resonance and fetal Doppler imaging. Antenatal
more » ... g. Antenatal diagnosis of a type 4 sacrococ-cygeal teratoma turned out to be meconium ileus-peritonitis during postpartum laparotomy and cystic fibrosis was final diagnosis. Conclusion: When an intraabdominal mass is seen in a fetus with ultrasonograghy and magnetic resonance, especially accompanied by ascites, intraabdominal calcifications and bowel dilatations, meconium peritonitis and ileus should be considered in the differential diagnosis. Prenatal sakrokoksigeal teratom tan›s› alm›fl bir mekonyum ileus-peritonit olgusu Amaç: Mekonyum ileus tan›s›ndaki zorluklar ve tan›da fetal manyetik rezonans görüntülemenin yerini tart›flmak. Olgu: Yirmidört yafl›nda, 33 hafta 3 günlük tekil gebeli¤i mevcut hastada, obstetrik ultrasonografi, manyetik rezonans ve fetal Doppler incelemelerinde, fetal pelvis yerleflimli, 66x56 mm boyutlar›nda, semisolid, yer yer kalsifikasyonlar içeren, vaskülarite gös-termeyen kitle ve polihidramnios saptanmas› üzerine hospitalize edilmifltir. Bu antenatal incelemeler sonucu tip 4 sakrokoksige-al teratom öntan›s› alan fetus, do¤umu takiben yap›lan laparotomi s›ras›nda mekonyum ileus-peritonit olarak de¤erlendirilmifl ve ileri tetkiklerde kistik fibrozis saptanm›flt›r. Sonuç: Ultrasonografi ve manyetik rezonans görüntüleme fetusta bat›nda kitle izlenmesi halinde, özellikle de asit, intraabdomi-nal kalsifikasyon, barsak dilatasyonu gibi bulgular efllik ediyorsa mekonyum ileusu ve peritoniti ay›r›c› tan›da düflünülmelidir. Anahtar Sözcükler: Mekonyum periteniti, sakrokoknigeal teratoma, magnetik rezonans.
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