The Experts below are selected from a list of 321 Experts worldwide ranked by ideXlab platform
V Tsatsaris - One of the best experts on this subject based on the ideXlab platform.
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Meconium Peritonitis in both fetuses with early twin-to-twin transfusion syndrome
Twin Research and Human Genetics, 2012Co-Authors: Louis Marcellin, Andrea Quintana, Houria Salhi, M. Essaoui, L. Boujenah, Olivia Anselem, Sylvie Beaudoin, V TsatsarisAbstract:Twin-to-twin transfusion syndrome (TTTS) is due to unbalanced inter-twin bloodflow through placental vascular anastomoses. We present a TTTS case treated with fetoscopic laser photocoagulation (FLP) that was complicated by perinatal Meconium Peritonitis in both twins. Ten weeks following laser treatment, the two fetuses showed intra-abdominal hyperechogenicity and ascites. After birth, the two newborns were surgically managed for Peritonitis. We discuss the pathogenesis of this double insult. The present case highlights the role of end-circulation bowel thrombi as the potential cause of subsequent intestinal perforation.
David Chitayat - One of the best experts on this subject based on the ideXlab platform.
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fetal Meconium Peritonitis prenatal findings and postnatal outcome a case series systematic review and meta analysis
Ultraschall in Der Medizin, 2020Co-Authors: Shiri Shinar, Swati Agrawal, Michelle Ryu, Tim Van Mieghem, Alan Daneman, Greg Ryan, Augusto Zani, Priscilla P L Chiu, David ChitayatAbstract:Purpose To describe the postnatal outcome of fetal Meconium Peritonitis and identify prenatal predictors of neonatal surgery. Methods We retrospectively reviewed all fetuses with ultrasound findings suspicious for Meconium Peritonitis at a single center over a 10-year period. A systematic review and meta-analysis were then performed pooling our results with previous studies assessing prenatally diagnosed Meconium Peritonitis and postnatal outcome. Prenatal sonographic findings were analyzed to identify predictors for postnatal surgery. Results 34 cases suggestive of Meconium Peritonitis were diagnosed at our center. These were pooled with cases from 14 other studies yielding a total of 244 cases. Postnatal abdominal surgery was required in two thirds of case (66.5 %). The strongest predictor of neonatal surgery was Meconium pseudocyst (OR [95 % CI] 6.75 [2.53–18.01]), followed by bowel dilation (OR [95 % CI] 4.17 [1.93–9.05]) and ascites (OR [95 % CI] 2.57 [1.07–5.24]). The most common cause of intestinal perforation and Meconium Peritonitis, found in 52.2 % of the cases, was small bowel atresia. Cystic fibrosis was diagnosed in 9.8 % of cases. Short-term neonatal outcomes were favorable, with a post-operative mortality rate of 8.1 % and a survival rate of 100 % in neonates not requiring surgery. Conclusion Meconium pseudocysts, bowel dilation, and ascites are prenatal predictors of neonatal surgery in cases of Meconium Peritonitis. Fetuses with these findings should be delivered in centers with pediatric surgery services. Though the prognosis is favorable, cystic fibrosis complicates postnatal outcomes.
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Meconium Peritonitis the role of postnatal radiographic and sonographic findings in predicting the need for surgery
Pediatric Radiology, 2018Co-Authors: Pablo Carodominguez, David Chitayat, Augusto Zani, Alan DanemanAbstract:The role of imaging in Meconium Peritonitis is not limited to establishing a diagnosis; rather, it might also be helpful in determining which neonates require surgery. However, few data in the literature correlate the postnatal radiographic and sonographic findings with the need for surgery. To compare the role of postnatal radiographic and sonographic findings in predicting the need for surgery in neonates with Meconium Peritonitis. We conducted a retrospective analysis of clinical, imaging and surgical findings in all neonates with Meconium Peritonitis in the period 1999–2014. We divided the children into operative or non-operative groups and then correlated each group with the presence or absence of the following findings on both the radiographs and sonograms: peritoneal calcification, Meconium pseudocyst, intestinal obstruction, volvulus, ascites and pneumoperitoneum. Thirty-seven neonates (22 males, 15 females) had Meconium Peritonitis in this period, of whom 23 (62%) required surgery and 14 (38%) were successfully treated non-surgically. None had an antenatal infection and three had cystic fibrosis (8%). Bowel obstruction identified on radiography (12/23, P=0.01) and sonography (9/23, P=0.04) and ascites identified with sonography (7/23, P=0.01) were associated with the need for surgical intervention. The presence of pneumoperitoneum and volvulus were also associated with surgical intervention. There was no significant statistical difference in the number of neonates with diffuse peritoneal calcification who were treated operatively or non-operatively. Four (33%) of the 12 neonates with Meconium pseudocysts were successfully treated non-operatively. Imaging findings that predicted the need for surgery were intestinal obstruction, ascites, volvulus and pneumoperitoneum. Neonates with Meconium pseudocysts did not require surgery if they were not associated with the described findings. The findings in our patients also indicate that those with diffuse peritoneal calcification as an isolated finding can be successfully treated non-operatively.
Louis Marcellin - One of the best experts on this subject based on the ideXlab platform.
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Meconium Peritonitis in both fetuses with early twin-to-twin transfusion syndrome
Twin Research and Human Genetics, 2012Co-Authors: Louis Marcellin, Andrea Quintana, Houria Salhi, M. Essaoui, L. Boujenah, Olivia Anselem, Sylvie Beaudoin, V TsatsarisAbstract:Twin-to-twin transfusion syndrome (TTTS) is due to unbalanced inter-twin bloodflow through placental vascular anastomoses. We present a TTTS case treated with fetoscopic laser photocoagulation (FLP) that was complicated by perinatal Meconium Peritonitis in both twins. Ten weeks following laser treatment, the two fetuses showed intra-abdominal hyperechogenicity and ascites. After birth, the two newborns were surgically managed for Peritonitis. We discuss the pathogenesis of this double insult. The present case highlights the role of end-circulation bowel thrombi as the potential cause of subsequent intestinal perforation.
Mingkwang Shyu - One of the best experts on this subject based on the ideXlab platform.
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correlation of prenatal ultrasound and postnatal outcome in Meconium Peritonitis
Fetal Diagnosis and Therapy, 2003Co-Authors: Mingkwang Shyu, Jinchung Shih, Chiennan Lee, Hsiaolin Hwa, Songnan Chow, Fonjou HsiehAbstract:Objectives: To study the relationship between prenatal ultrasound features and postnatal course of Meconium Peritonitis. Methods: Meconium Peritonitis was diagnosed by prenatal ultrasound. Fetuses were treated by intrauterine paracentesis of ascites when indicated, and symptomatic newborns received surgery. Results: Totally 17 cases were enrolled. Prenatal ultrasound findings include abdominal calcification (16/17), fetal ascites (12/17), hydramnios (9/17), pseudocyst (7/17) and dilated bowel loop (6/17). Persistent ascites, pseudocyst or dilated bowel loop are most sensitive (92%) to predict postnatal surgery (p = 0.022). The survivors have a higher gestational age at birth (36.4 vs. 33.3 weeks, p = 0.008). Persistent ascites and postnatal persistent pulmonary hypertension of the newborns significantly correlate with neonatal mortality (p = 0.029 and 0.022). Conclusion: Prenatal ultrasound can predict the neonatal outcome in Meconium Peritonitis.
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intrauterine intervention in a case of recurrent Meconium Peritonitis
Prenatal Diagnosis, 1994Co-Authors: Mingkwang Shyu, Chin Der Chen, M Fonjou D Hsieh, Kuoinn Tsou Yau, Ghijen Lin, Mingliang LeeAbstract:We present a case of recurrent Meconium Peritonitis detected in the second trimester and treated by intrauterine intervention. Antenatal ultrasound findings included fetal ascites and intra-abdominal calcification. Aspiration of fetal ascites under ultrasound guidance and determination of the bilirubin concentration established the diagnosis of Meconium Peritonitis. Paracentesis was repeated to remove irritating intestinal contents and to decrease pressure on the fetal thorax. Although the exact cause of the Meconium Peritonitis remains unknown, the recurrence of the condition suggests a genetic basis. A possibility of cystic fibrosis was not considered because the clinical picture did not suggest it. Intrauterine intervention helped to establish the diagnosis of Meconium Peritonitis and may have contributed to the good outcome.
Con Metreweli - One of the best experts on this subject based on the ideXlab platform.
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case report antenatal sonographic diagnosis of Meconium Peritonitis and subsequent evolving Meconium pseudocyst formation without peritoneal calcification
Brain and Language, 1997Co-Authors: Wei Tse Yang, Con MetreweliAbstract:A case of giant Meconium pseudocyst secondary to rupture from intestinal obstruction diagnosed by in utero sonography is presented_ The diagnosis of intestinal obstruction was made in the late second trimester before development of polyhydramnois, and the diagnosis of Meconium cyst made in the third trimester despite the absence of intra-abdominal calcification. Exploratory laparotomy immediately after birth revealed a giant pseudocyst at the site of rupture immediately proximal to distal ileal atresia with associated in utero volvulus. Conventional radiographic features of Meconium Peritonitis with secondary Meconium cyst formation are well described [1-6]. With the advent of high resolution real time ultrasound (US), the special role of sonography in detecting congenital malformations in utero has been established. We present a case in which sonographic diagnosis of intestinal obstruction was made at 27 weeks gestation before the development of polyhydramnois, and a sonographic diagnosis of Meconium pseudocyst was made at 36 weeks gestation despite the absence of intra-abdominal calcification. Laparotomy at 10 h of life confirmed ileal atresia with associated volvulus and a large pseudocyst at the rupture site in the distil ileum. Small bowel resection and anastomosis were performed after 500 ml of greenish brown fluid were drained fi'om the pseudocyst. Pathology of the resected small bowel specimen did not reveal any calcification intraluminally or on the serosal surface. The baby recovered well postoperatively and has achieved normal developmental milestones. Subsequently, a sweat test was normal.