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Diagnóstico prenatal de peritonitis meconial y fibrosis quística: reporte de un caso clínico.
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- Author(s): López, A. Soria; Guzmán López, A.; Saldivar Rodríguez, D.; Valdéz Chapa, DL; Triana Saldaña, H.; Elizondo Briseño, JA; Galindo Reyes, C.; Treviño Ledesma, W; Hernández León, J.
- Source:
Medicina Universitaria. ene-mar2003, Vol. 5 Issue 18, p41-43. 3p.- Subject Terms:
- Source:
- Additional Information
- Alternate Title: Prenatal diagnosis of meconium peritonitis and cystic fibrosis.
- Abstract: Meconium peritonitis is a rare condition occurring in 1/35,000 live births. Any condition causing bowel obstruction may be responsible for bowel distension and perforation, leading to a sterile chemical peritonitis Meconium ileus, which is related to cystic fibrosis in 90% of cases, accounts for less than 25%. More frequently, mechanical bowel obstruction is provoked by intestinal atresia, volvulus, intussuseption or herniation. Polyhydramnios is present in 10-64% of cases and has been attributed to difficulty in swallowing as the result of deficient bowel peristalsis. On rare occasions, fetal hydrops may be present. Prenatal diagnosis is suspected when fetal intra-abdominal calcifications are observed, especially in association with fetal ascites and polyhydramnios. Fetal bowel obstruction associated with fast developing fetal ascites or hydrops is usually noted. On rare occasions, however, fetal ascites regresses, intestinal dilatation disappears and peristalsis reappears. Only hyperechoic area remains. Sometimes, intraabdominal meconium pseudocysts are the sole remnants of the meconium peritonitis. It is presented the case of a forty year-old female patient, five para, 36.2 pregnancy, with US that reported ascitis, dilated bowel, intraabdominal calcification, making diagnosis of meconial peritonitis, with positive markers for cystic fibrosis. [ABSTRACT FROM AUTHOR]
- Abstract: La peritonitis meconial es un padecimiento raro con una incidencia de 1 en 35.000 casos. Cualquier condición que provoque obstrucción intestinal puede ser la responsable, con la consecuente peritonitis química estéril. En 90% de los casos la fibrosis quistica puede manifestarse con íleo meconial y ser responsable del 25% de la peritonitis meconial. El origen más frecuente es una obstrucción mecánica intestinal, cualquiera que sea su causa, como atresia intestinal, vólvulos, intususcepción o herniación. El polihidramnios es un dato ullrasonográfico en 10 a 64% de los casos, debido a la dificultad de digerir el liquido amniótico por peristaltismo deficiente. En raras ocasiones se encuentra hidrops fetal como dato ullrasonográfico. El diagnóstico prenatal se sospecha cuando hay calcificaciones intraabdommales, en especial, si aparece ascitis fetal y polihidramnios. A veces permanecen áreas hiperecoicas con pseudoquistes meconiales intraabdominales que son vestigios de peritonitis meconial y, en raras ocasiones, estos datos desaparecen, inclusive la obstrucción intestinal, y el peristaltismo se normalizan. Se analiza el caso de una paciente de 40 años de edad con una quinta gestación, que cursa con embarazo de 36.2 semanas. Se practicó un ultrasonido fetal que reporta ascitis, asas intestinales dilatadas y calcificaciones intraabdominales, por lo que se diagnosticó peritonitis meconial, confirmada como agente causante la fibrosis quística, apoyada con marcadores positivos. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Medicina Universitaria is the property of Medicina Universitaria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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