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[Prenatal and neonatal management of digestive tract duplications. Diagnostic difficulties and therapeutic
F Becmeur1, B Viville, B Langer
1Service de Chirurgie Infantile, Hôpitaux Universitaires de Strasbourg.
Insights
Diagnosing digestive duplications antenatally is challenging. Complete malformative screening and prompt neonatal management are crucial for conditions like small bowel duplications requiring potential emergency surgery.
Area of Science:
- Medical Imaging
- Pediatric Surgery
- Fetal Medicine
Background:
- Digestive duplications present diagnostic challenges during prenatal screening.
- These congenital anomalies require careful evaluation due to potential complications.
Observation:
- Cystic duplications of the tongue, abdomino-thoracic transdiaphragmatic duplications, and small bowel duplications are discussed.
- Comparison with literature cases highlights the spectrum of these rare malformations.
Findings:
- Antenatal diagnosis of digestive duplications is difficult, necessitating thorough malformative screening.
- Foregut duplications frequently coexist with other congenital anomalies.
- Small bowel duplications can lead to postnatal mechanical complications requiring urgent surgical intervention.
Implications:
- Prenatal ultrasound should aim to detect alimentary tract duplications.
- Comprehensive antenatal screening is essential for identifying associated malformations.
- In utero transfer may be necessary for fetuses requiring immediate postnatal surgical management.
Objective:
To insist on the difficulty of the antenatal diagnosis of digestive duplications, to show the importance of a complete malformative screening, and the need for immediate management at birth.
Material And Methods:
A cystic duplication of the tongue, a duplication, abdomino-thoracic transdiaphragmatic, and a duplication of the small bowel are described and compared with cases previously reported in th literature.
Results:
Antenatal evacuation puncture of a duplication of the tongue must be reserved for exceptional situations. Foregut duplications are often associated with other malformations. The duplication of the small intestine can exceptionally expose to a mechanical complication, mostly during the postnatal period, which may require emergency surgery.
Conclusion:
Duplications of the alimentary tract should be detectable on prenatal ultrasound examination. A complete antenatal malformative screening is required and in utero transfer is warranted because emergency surgery may be required.