Meconium peritonitis presenting with nonimmune hydrops and mirror syndrome

Meconium peritonitis (MP) presenting as hydrops is a rare entity. A 34-week hydropic infant was born to mother diagnosed with a case of nonimmune hydrops. Postnatally, the neonate was diagnosed as a case of MP based on clinical examination and investigations. The neonate underwent exploratory laparotomy which revealed diffuse MP with ileal perforation. She underwent resection of ileal perforation with ileocolic anastomosis. The index case highlights the importance of thorough clinical examination and abdominal X-ray in the diagnosis of MP.