E4846. Meconium Happens: Multimodality Guide to Recognizing Meconium Pseudocysts in Neonates
  1. Claire Meriwether; Department of Radiology, UC San Diego Health
  2. John Naheedy; Rady Children's Hospital
Meconium pseudocyst is a relatively uncommon, but important neonatal diagnosis. While it is the result of bowel injury during gestation, it tends to be seen by imaging in the newborn period. Meconium pseudocysts can develop in the setting of in utero bowel perforation, resulting in meconium spillage and peritonitis. The etiology of fetal bowel perforation is variable and can range from spontaneous to mechanical (e.g., volvulus or ileus) to congenital (e.g., atretic bowel). Exhibit viewers will also learn about the management of meconium pseudocysts.

Educational Goals / Teaching Points
The purpose of this exhibit is to educate radiologists and radiology trainees about the diagnosis of meconium pseudocyst by reviewing clinical presentations and key imaging findings across multiple imaging modalities. Meconium pseudocysts can easily be mistaken for other pathologies, but they are essential for radiologists to recognize and accurately diagnosis to ensure neonates receive timely and appropriate intervention. It is critical for not only pediatric radiologists, but also any radiologist who may encounter newborns in their practice via the NICU or emergency room to be familiar with this entity.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Utilizing a variety of illustrative and engaging cases, this educational exhibit will review imaging findings that suggest a diagnosis of meconium pseudocyst on radiography, ultrasound, and MRI. Importantly, the exhibit will also delve into potential pitfalls using cases that illustrate other entities with potentially similar imaging appearances, such as ovarian torsion and lymphatic malformations.

It is essential for all radiologists who may encounter newborns in their practice to be familiar with the diagnosis of meconium pseudocyst and its appearance on multiple imaging modalities.