Meconium pleuritis (meconium thorax) occurs when meconium is released into the pleural space.


Risk factors:

(1) rupture of the colon with release of meconium and variable meconium peritonitis

(2) defect in the diaphragm with communication between pleural space and peritoneum


With congenital diaphragmatic hernia (including Bochdalek hernia) incarceration of bowel can result in release of meconium directly into the pleural space.


Clinical features:

(1) respiratory distress

(2) significant clinical deterioration associated with bowel perforation

(3) meconium-colored pleural fluid


Imaging studies may demonstrate abdominal viscera in the thorax but not always (helpful if present but not if absent).


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