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Meconium Periorchitis

Journal of Perinatology volume 24, pages 188–190 (2004)Cite this article

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The patient was taken to the operating room for an inguinal exploration. The gritty scrotal mass was inseparable from the testicle and an orchitectomy was performed. The pathology specimen demonstrated a normal testicle surrounded by calcifying meconium periorchitis (MPO).

MPO is a rare condition occuring in infant boys who have had healed meconium peritonitis.1 Meconium is the greenish, viscous intestinal content of the distal small bowel present after the fourth month of fetal life. It contains swallowed amniotic fluid, bile salts, bile pigments, cholesterol, mucin, pancreatic enzymes, intestinal enzymes, squamous cells, lanugo hair and other cellular debris. Meconium peritonitis occurs when a bowel wall rupture occurs during late fetal life or early postnatal life allows meconium to enter the peritoneal cavity. This may be associated with voluvulus, bowel atresia, or mesenteric vascular insufficiency.2 If the ruptured bowel wall heals, there may be no evidence of the cause or the site of perforation. This has been called healed meconium peritionitis. Meconium in the peritoneal cavity initiates a sterile, chemical foreign body peritonitis.3 Peritoneal calcifications may develop subsequently. Three forms have been described: fibroadhesive, either localized or generalized, and cystic.3 The localized fibroadhesive is the most common resulting in linear peritoneal calcifications. The generalized variety may have ascites. Cystic meconium peritonitis occurs when the perforated meconium is localized adjacent to the bowel loop resulting in a focal cystic mass that appears as a thin-walled calcified cyst radiographically.4 Extra-abdominal complications of meconium peritonitis have been described2,5 including passage of meconium into the scrotum through a patent processus vaginalis and into the thoracic cavity through the foramen of Bochdalek and systemic embolization of meconium. Passage through the patent processus vaginalis in a male may result in MPO.

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  1. Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St. Louis, MO, USA

    Thomas E Herman MD & Marilyn J Siegel MD

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  1. Thomas E Herman MD
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  2. Marilyn J Siegel MD
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Herman, T., Siegel, M. Meconium Periorchitis. J Perinatol 24, 188–190 (2004). https://doi.org/10.1038/sj.jp.7211045

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