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.