Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Meconium Periorchitis

Journal of Perinatology volume 24, pages 53–55 (2004)Cite this article

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 occurring 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, allowing 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 peritonitis. 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 meconium periorchitis.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

References

  1. Dehner LP, Scott D, Stocker JT . Meconium periorchitis: a clinicopathologic study of four cases with a review of the literature. Hum Pathol 1986;17:807–812.

    Article  CAS  Google Scholar 

  2. Boccon-Gibod L, Roucayrol AM . Meconium periorchitis. Pediatr Pathol 1992;12:851–856.

    Article  CAS  Google Scholar 

  3. Kimball D, Smith W . Meconium peritonitis with thoracic extension. AJR 1985;144:113–114.

    Article  CAS  Google Scholar 

  4. Carroll BA, Moskowitz PS . Sonographic diagnosis of neonatal meconium cyst. AJR 1981;137:1262–1264.

    Article  CAS  Google Scholar 

  5. Patton WL, Lutz AM, Willmann J, Callen P, Barkovich AJ, Gooding CA . System spread of meconium peritonitis. Pediatr Radiol 1998;28:714–716.

    Article  CAS  Google Scholar 

  6. Varkonyi I, Fliegel C, Rosslein R, Jenny P, Ohnacker H . Meconium periorchitis: case report and literature review. Europ J Pediatr Surg 2000;10:404–407.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mallinckrodt Institute of Radiology Washington University School of Medicine, St. Louis, MO, USA

    Thomas E Herman MD & Marilyn J Siegel MD

Authors
  1. Thomas E Herman MD
    View author publications

    Search author on:PubMed Google Scholar

  2. Marilyn J Siegel MD
    View author publications

    Search author on:PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Herman, T., Siegel, M. Meconium Periorchitis. J Perinatol 24, 53–55 (2004). https://doi.org/10.1038/sj.jp.7211014

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/sj.jp.7211014

Search

Advanced search

Quick links