Ultrasonographic diagnosis of intestinal malrotation with midgut volvulus in fetus

Abstract

Objective To discuss the prenatal ultrasound manifestations of intestinalmalrotation with midgut volvulus. Methods An analysis of prenatal ultrasound findings and postnatal features was performed on five cases of fetuses with intestinal malrotation with midgut volvulus that were identified by ultrasonography at Beijing Obstetrics and Gynecology Hospital, in the period of January 2014 to May 2016. Results The 5 fetuses with intestinal malrotation with midgut volvulus were diagnosed based on the typical whirlpoolsign in ultrasonography. Indirect and non-specificultrasonographic signs included coffee bean sign , pseudocysts and ascites. Obstetric management and follow-up results: 2 cases emergency caesarian section were performed, infantstransferred to pediatric surgery, the intraoperative findings confirmed the prenatal diagnosis, postoperative the infants made an uneventful recovery. Another 3 cases suggesting the presence of meconium peritonitis, fetus born via a spontaneous vaginal delivery, the intraoperative findings confirmed the prenatal diagnosis, concurrent intestinal atresia, resectionof about 60 to 90 cm of atresia ileum, postoperative the infants showed symptoms of shortbowel syndrome. Conclusions Fetuses with intestinal malrotation with midgut volvulushad characteristic whirlpool sign in ultrasonography.Ultrasonography may be used as the first choice for prenatal diagnosis of this disease. Prenatal diagnosis of intestinal malrotation with midgut volvulus can provide guidance for clinical obstetrical management and postnatal treatment. Key words: Ultrasonography, prenatal; Fetus; Congenital abnormalities; Intestinal volvulus