EP12.25: Fetal spontaneous resolution of small bowel volvulus: prenatal ultrasound and MRI diagnosis and neonate issue

Abstract

The aim of these study was to describe the prenatal spontaneous resolution of small bowel volvulus using ultrasound and MRI examinations and the neonate outcome. A retrospective descriptive study was leaded in our university hospital centre during ten years. Inclusion criteria was fetal intestinal volvulus diagnosed by ultrasound and MRI with complete prenatal resolution. The ultrasound diagnosis was done using 2D and colour Doppler imaging. For each fetus prenatal ultrasound examination was completed by MRI. Ultrasound and MRI semiology were studied and compared. A weekly ultrasound fetal survey was performed. All the neonates had pediatric surgeon examination and an abdominal ultrasound scan was done. 3 fetuses were included. Mean gestational age of mid-gut volvulus diagnosis was 29.8 WG. The ultrasound imaging revealed only the 2D and colour Doppler “whirlpool sign”. The usual indirect ultrasound signs were not found in these three cases. The confirmation by MRI was effective in each case when winding dilated loops was highlighted. In our series no volvulus by intestinal malrotation was revealed. Antenatal outcome was spontaneous resolution with complete disappearance of the ultrasound sign of intestinal volvulus. Neonates outcome was normal with no intestinal complication found in all cases. Fetal ultrasonographic examination can done the diagnosis of small bowel volvulus. MRI is the exam which permit to confirm it. Spontaneous resolution of the fetal volvulus is possible and was described in three cases in our series of 13 prenatal cases of small bowel volvulus. The neonate prognosis was excellent.