Ultrasound images show very high amplitude echoes with posterior acoustical shadowing along the peritoneal surface in the right lower quadrant.

 There are also high amplitude echoes seen ventral to the liver and in Morrison’s pouch.

 The right adrenal gland and right kidney are normal.     

 Meconium peritonitis occurs when the bowel ruptures in utero resulting in calcification of the peritoneum within hours to days. 

 This can occur in patients who are now normal or can occur in those with meconium ileus(Figure) due to cystic fibrosis(CF).

 The meconium is more likely to calcify in those patients who do not have cystic fibrosis.

Up to 20% of patients with CF have meconium ileus and half of those develop meconium peritonititis. 

    Patients with meconium peritonitis may have associated pseudocysts, ascites or bowel dilatation.

 The prognosis becomes worse with increasing number of associated findings. Treatment may require surgery which usually results in a good outcome.

In those patients with isolated peritoneal calcification, surgery is not usually required and patients usually are asymptomatic and this patient needed no treatment. 

MNEMONIC for MICROCOLON; MIMCA

M-Meconium ileus

I- Ileal atresia

M- Megacystits microcolon hypoperistalsis syndrome

C- Colonic atresia

A- Aganglionosis- Hirschsprung disease