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Published on: October 29, 2014
Dilated and echogenic fetal bowel and postnatal outcomes: a surgical perspective. Case series and literature review
C R Jackson1, J Orford, C Minutillo
1Royal Hospital for Sick Children, Department of Paediatric Surgery, Edinburgh, United Kingdom. clairejackson@doctors.org.uk
Insights
Antenatal ultrasound findings of echogenic bowel are non-specific but can indicate potential bowel obstruction. While associated with increased fetal loss, most neonates with isolated echogenic bowel have good surgical outcomes if intervention is needed.
Area of Science:
- Perinatology
- Pediatric Surgery
- Fetal Medicine
Background:
- Echogenic bowel and dilated bowel on antenatal ultrasound are recognized markers for various fetal conditions.
- These conditions include bowel obstruction, chromosomal abnormalities, infections, and cystic fibrosis.
Purpose of the Study:
- To review surgical interventions and outcomes for infants with antenatally diagnosed isolated echogenic bowel or dilated bowel.
- To assess the significance of intra-abdominal echogenic foci.
Main Methods:
- A 5-year retrospective clinical review was conducted.
- Infants with isolated echogenic bowel and/or dilated bowel or intra-abdominal echogenic foci were analyzed.
Main Results:
- Thirty-five fetuses presented with abnormal antenatal findings.
- Twelve infants required surgery for conditions like intestinal atresia, meconium ileus, and duplication cysts.
- Postoperative outcomes for these infants were generally good.
Conclusions:
- Antenatal echogenic bowel is a non-specific indicator of fetal disorders, with a majority of neonates being normal at birth.
- Bowel dilatation, with or without echogenicity, often predicts the need for surgical intervention for obstruction.
- Surgical outcomes for neonatal bowel obstruction are favorable; isolated echogenic foci in the abdomen have minimal postnatal significance.
Introduction:
Foetal dilated or echogenic bowel have been described as markers for a variety of conditions including bowel obstruction, chromosomal and infectious disorders and cystic fibrosis. We aim to describe possible surgical interventions and outcomes.
Methods:
A 5-year review was performed of the clinical course of infants with antenatally diagnosed isolated echogenic bowel and/or dilated bowel or intraabdominal echogenic foci presenting at Princess Margaret Hospital for Children, Perth, Western Australia.
Results:
Abnormal antenatal findings were present in 35 foetuses. Twelve babies underwent surgery for intestinal atresia, meconium ileus and duplication cysts. Postoperative courses and outcomes were good.
Conclusions:
Echogenic bowel on antenatal ultrasound is a non-specific marker for a variety of disorders. Although associated with higher rates of foetal loss, the majority of neonates are normal at delivery. Bowel dilatation with or without echogenicity is often predictive of bowel obstruction requiring surgery. Surgical outcomes are, however, very good. Echogenic foci elsewhere in the abdomen have little postnatal significance.
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