Meconial peritonitis in a rare association of partial ileal apple-peel atresia with small abdominal wall defect


Submitted: 13 November 2014
Accepted: 13 November 2014
Published: 30 June 2014
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Authors

  • V. Insinga Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università degli Studi di Palermo, Palermo, Italy.
  • M. Pensabene Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università degli Studi di Palermo, Palermo, Italy.
  • M. Giuffrè Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università degli Studi di Palermo, Palermo, Italy.
  • M. Busè Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università degli Studi di Palermo, Palermo, Italy.
  • M. Cimador Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università degli Studi di Palermo, Palermo, Italy.
  • G. Corsello Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università degli Studi di Palermo, Palermo, Italy.
  • F. Siracusa Dipartimento di Scienze per la Promozione della Salute e Materno Infantile, Università degli Studi di Palermo, Palermo, Italy.
Intestinal atresia type III B (apple peel) and gastroschisis are both congenital malformations who require early surgical correction in neonatal age. Their association is very rare. We present the case of a full term infant with partial apple peel ileal atresia and a small defect of the anterior abdominal wall, complicated by in utero intestinal perforation and subsequent meconial peritonitis. We observed a partial atresia of small intestine, with involvement of terminal ileus savings of jejunum and a large part of the proximal ileum, small anterior abdominal wall defect with herniation of few bowel loops, intestinal malrotation. Paralytic ileus and infections are the main causes of morbidity and mortality at neonatal age. In our case, in spite of the mild phenotype, prognosis has been complicated by the onset of functional bowel obstruction, caused by chemical peritonitis resulting from contact with either amniotic fluid and meconium.

Insinga, V., Pensabene, M., Giuffrè, M., Busè, M., Cimador, M., Corsello, G., & Siracusa, F. (2014). Meconial peritonitis in a rare association of partial ileal apple-peel atresia with small abdominal wall defect. La Pediatria Medica E Chirurgica, 36(3). https://doi.org/10.4081/pmc.2014.8

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