ABSTRACT Background: In certain situations, the radiologist may be the first physician to suggest the presence of paediatric abnormality. The need of early diagnosis of potentially life- threatening emergency conditions is now becoming one of the important contributions of ultrasound to the referring clinician. Our case presentation demonstrates the value sonographic diagnosis of meconium peritonitis. Case description: We present a case of term infant who was diagnosed to have echogenic bowel with few specks of peritoneal calcification and loculated ascites. Early detection with ultrasound led to immediate surgical intervention and patient recovered without any immediate or long term complications. Conclusion: Meconium peritonitis (MP) is a chemical peritonitis caused by fetal intestinal perforation which occurs mostly in utero. Its incidence is extremely rare, but serious neonatal morbidity or even mortality can occur if the diagnosis is not made until after birth. Prenatal diagnosis is essential in prompting early postnatal surgical intervention, and also improving neonatal outcome.

Keywords: ultrasound, ascites, Meconium peritonitis, case report