PERINATOLOGY • Vol 24 • No. 1 • May–Aug 2023 • 67 Case Report Meconium Peritonitis: Missed Opportunities and Diagnostic Challenges Maria Paula Alvarez Saenz, Delia Theurel Martin, Juan Pablo Otoya Castrillon, Crisar Guerrero Quiroz, Edwin Medina Medina, Jorge Luis Alvarado Socarras* *Correspondence Dr Jorge Luis Alvarado Socarras Pediatric Neonatologist (Unit of Neonatology) Department of Pediatrics Universidad de Santander Fundacion Cardiovascular de Colombia Street 155A No. 23-58 Floridablanca 680003 Santander, Colombia E-mail: jorgealso2@yahoo.com Abstract Meconium peritonitis causes conditions such as adynamic ileus, intestinal obstruction by flanges, and short bowel in neonates. The clinical spectrum of this state can vary from a mild condition that does not require surgical management to a severe state that results in high mortality rate despite surgical correction. A male neonate was born at 37 weeks of gestation to a 25-year-old woman in Fundacion Cardiovascular de Colombia (Santander, Colombia). The neonate clinically deteriorated at birth, with abdominal distension and changes in the color of the abdominal wall. The condition was postnatally diagnosed as meconium peritonitis. The condition required surgical treatment in 2 stages—intestinal resection and double-mouth ileostomy with subsequent terminal anastomosis. The neonate was examined thoroughly to find the cause for the meconium peritonitis that is secondary to mechanical, physiological, or infectious obstruction. Key Words: Meconium peritonitis, meconium ileus, intestinal obstruction, cystic fibrosis, ileus, meconium cyst Introduction Meconium peritonitis, a secondary sterile peritoneal irritation due to intestinal perforation, has multiple etiologies and can occur after the 20th week of gestation until the first hour of life. Prenatal diagnosis of this condition is possible when there are prenatal ultrasound findings such as ascites, diffuse intra-abdominal
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