Neonatal Course:
A large scrotum was noted upon physical exam (Figure 3) and postnatal
testicular ultrasound performed on day of life zero (DOL) was consistent
with meconium periorchitis. Abdominal X-ray noted large loculated
appearing pneumoperitoneum collection over the central upper abdomen.
Exploratory laparotomy was performed on DOL 1, meconium and meconium
pseudocyst were noted without overt bowel perforation. Small bowel
resection was performed with ileostomy. The bilateral inguinal rings
were inspected and noted to be plugged with meconium. On DOL 42
ileostomy reversal was performed with resection of 10 cm of terminal
Ileum and right colon with side-by-side anastomosis. Urology was
consulted and recommended conservative management with follow up showing
improvement in meconium hydroceles.