Fetal Bowel Dilatation: A Sonographic Sign of Uncertain Prognosis.

Patrícia Silva,Filipa Reis,Paulo Alves,Pilar Câmara,Manuel Sousa Gomes,Luís Farinha

doi:10.1155/2015/608787

Patrícia Silva, Filipa Reis + Show 4 more

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https://doi.org/10.1155/2015/608787

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Abstract

Fetal bowel dilatation is an indirect sonographic sign of mechanical or functional bowel obstruction. The etiology of fetal bowel dilatation is a difficult prenatal diagnosis since ultrasound has limited accuracy for bowel evaluation. The authors describe a case of fetal bowel dilatation diagnosed in the third trimester.

Highlights

Fetal bowel dilatation is characterized by fluid-filled intestinal loops which measure at least 15 mm in length or 7 mm in diameter [1]
Ultrasonographic image of dilated fetal bowel is a sign of intestinal mechanical or functional obstruction and its prevalence will depend on the underlying condition: bowel atresia or stenosis, malrotation with volvulus, meconium ileus, total colonic aganglionosis, and meconium plug syndrome [2]
Exploratory laparotomy was performed on the second day of life and a proximal dilated ileum loop followed by an atresic “apple peel” portion, with approximately 45 cm, which terminated in 30 cm normal ileum was seen (Figure 5)

Summary

Introduction

Fetal bowel dilatation is characterized by fluid-filled intestinal loops which measure at least 15 mm in length or 7 mm in diameter [1]. Ultrasonographic image of dilated fetal bowel is a sign of intestinal mechanical or functional obstruction and its prevalence will depend on the underlying condition: bowel atresia or stenosis, malrotation with volvulus, meconium ileus, total colonic aganglionosis, and meconium plug syndrome [2]. The difference between dilated small bowel loops and colon by ultrasound imaging is challenging as is the accurate identification of the number and location of obstructions [4, 5]. Fetal bowel dilatation might be associated with different postnatal outcomes which makes the prenatal management and parental counseling problematic. The authors describe a case of fetal bowel dilatation in the third trimester, followed by a brief review of differential diagnosis and management

Presentation of the Case

Findings

Discussion