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Peritoneal Calcifications in a Newborn

Figure 1. Peritoneal calcifications

Iskandar Bouazid, Yasmine Ladjal

Keywords : Neonatal Intestinal Obstruction, neonates surgical emergency, intestinal atresia, peritoneal calcifications

Question:
A full term baby girl, born to a 27-year-old woman (gravida 1) at 38 weeks of gestation, presented at
48 hours age with generalized abdominal distention, bilious vomiting and failure to pass meconium. The mother had no medical history before and during pregnancy, prenatal ultrasound screenings were normal. A nasogastric tube was passed in the baby without problems. A simple thoracoabdominal radiography showed dilated loops of small intestine, air-fluid levels and multiple calcifications in the right lumbar region (black arrowhead on Fig.1). On abdominal ultrasonography, these scattered calcifications were also seen along with ascites, a very dilated bowel loop that was mistakenly identified as colon. Urgent exploratory laparotomy was done that revealed an ileal atresia 3 cm proximal to the ileocecal valve, with peritoneal adhesions. There were no other associated malformations. Due to the caliber disparity caused by the dilated ileum and to avoid any sacrifice at the expense of the precious terminal ileum; an ileostomy was performed after peritoneal cleansing.
What is the cause of peritoneal calcifications?