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April 1981

Maternal Meconium Granulomatous Peritonitis

Author Affiliations

From the Institute for Cardiovascular Diseases (Drs Bokhari, Desser, and Benchimol), and the Department of Obstetrics and Gynecology (Dr Mouer), Good Samaritan Hospital, Phoenix, Ariz.

Arch Intern Med. 1981;141(5):658-659. doi:10.1001/archinte.1981.00340050104024

• A 32-year-old woman underwent cesarean section because of fetal distress. Meconium spilled into the incision during delivery. The patient subsequently had a fever, right-sided pleuritic chest pain, a right lower lobe infiltrate, and a pleural effusion. Exploratory laparotomy disclosed intra-abdominal fibrosis with inflammatory mass formation. A biopsy specimen showed a granulomatous reaction around the bile-staining material similar to meconium. The patient was treated with prednisone, and her symptoms abated. During the next four years, episodes of fever, abdominal discomfort, and pleuritis recurred, which eventually responded to indomethacin therapy.

(Arch Intern Med 1981;141:658-659)