Meconium peritonitis results from which process?

• A. Bowel perforation
• B. Bowel atresia
• C. Duodenal atresia
• D. Esophageal atresia

Answer: (A)

Meconium peritonitis happens when the fetal bowel has perforated, allowing sterile meconium to spill into the peritoneal cavity. That leakage triggers a chemical peritonitis and often leads to calcifications or pseudocysts seen later. The key initiating event is the rupture of the bowel wall; without perforation, the meconium stays inside the bowel and peritonitis does not develop. Obstruction from atresia can be associated with pressure and may contribute to perforation, but it is the perforation itself that produces meconium peritonitis. Proximal atresias like duodenal or esophageal atresia do not directly cause peritoneal contamination with meconium.