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Congenital gastrointestinal system malformations in a 5-year post mortem series
1Department of Gynecologic and Perinatal Pathology, School of Medicine, University of Zagreb, Croatia.
Insights
Congenital gastrointestinal (G-I) tract malformations, primarily atresias, omphalocele, and gastroschisis, were analyzed in post-mortem cases. These G-I malformations showed a significant male predominance and were frequently associated with other organ system defects.
Area of Science:
- Pathology
- Developmental Biology
- Pediatric Surgery
Background:
- Congenital gastrointestinal (G-I) malformations represent a significant cause of perinatal morbidity and mortality.
- Understanding the spectrum and frequency of these anomalies is crucial for diagnosis and management.
Purpose of the Study:
- To determine the types and frequencies of congenital G-I tract malformations in post-mortem examinations.
- To analyze the association of G-I malformations with other congenital anomalies.
Main Methods:
- Retrospective review of autopsy protocols for aborted fetuses, stillborn infants, and infants deceased within 7 days (1996-2000).
- Exclusion of specific malformations (cleft lip/palate, biliary, pancreatic, diaphragmatic).
- Analysis of G-I malformation types, frequencies, and co-occurrence with other organ system defects.
Main Results:
- Gastrointestinal tract malformations were identified in 37 out of 1251 autopsies (2.9%).
- The most common G-I malformations were atresias (56.75%), followed by omphalocele (35.13%) and gastroschisis (8.1%).
- A male preponderance (2.36:1) was observed, and 62.2% of G-I malformations were associated with anomalies in other organ systems, notably cardiovascular and urogenital.
Conclusions:
- Congenital G-I tract malformations, particularly atresias, omphalocele, and gastroschisis, are significant findings in perinatal post-mortem studies.
- The high rate of associated anomalies underscores the systemic nature of many congenital G-I disorders.
- Further research into the etiology and management of these complex malformations is warranted.
Abstract:
The aim of this study was to determine the types and frequencies of congenital gastroinstestinal (G-I) tract malformations on post mortem in the period from 1996 to 2000. Autopsy protocols of aborted fetuses, stillborn infants and infants that died within 7 days after delivery were retrieved from the archive and studied. Cases of cleft lip and/or palate, biliary tract, pancreatic and diaphragmal malformations were not included in the study. During the mentioned period, 1251 autopsy was performed with 127 showing some malformation. G-I tract malformation was diagnosed in 37 cases (2.9% and 29.1%, respectively). Most frequent malformations were atresias at the different level of the G-I tract (56.75%), followed by omphalocoele (35.13%) and gastroschisis (8.1%). Of atresias, the most frequent were oesophageal and anorectal (38.1% of atresias, each). A striking male preponderance (2.36:1) in the frequency of G-I malformations was noticed. Isolated G-I malformations were found in 32.4%, different but simultaneous G-I malformations in 5.4% and association with other organ system(s) malformations in 62.2%. Omphalocoele and anorectal atresia were associated with other organ system malformation(s) in 34.8%, each. Other organ systems affected by malformation besides the G-I tract were cardiovascular system (65.21%), urogenital system (also 65.2%), gastrointestinal system with the malformation of another kind or atresia at the different level (17.4%), CNS (17.4%), skeletal system (26.1%) and other organs or systems (30.7%).