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Ileal atresia with meconium peritonitis: fetal MRI evaluation

Andrew J Degnan1, Dorothy I Bulas, Raymond W Sze

  • 1Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC, USA.

Journal of Radiology Case Reports
|April 4, 2012
PubMed

Insights

Fetal MRI accurately diagnosed ileal atresia with meconium peritonitis, a rare condition causing bowel obstruction in newborns. This imaging technique aids in prenatal diagnosis and management planning.

Area of Science:

  • Medical Imaging
  • Pediatric Surgery
  • Neonatology

Background:

  • Ileal atresia is a congenital condition causing intestinal obstruction.
  • Meconium peritonitis can result from fetal intestinal perforation.
  • Prenatal diagnosis of these conditions is crucial for timely intervention.

Purpose of the Study:

  • To report a case of ileal atresia with meconium peritonitis diagnosed prenatally.
  • To highlight the utility of fetal Magnetic Resonance Imaging (MRI) in evaluating this condition.

Main Methods:

  • A case of suspected abdominal mass on prenatal ultrasound was evaluated.
  • Fetal MRI was performed at 32 weeks gestation.
  • Postnatal diagnosis was confirmed via contrast enema and surgical exploration.

Main Results:

  • Fetal MRI identified a perihepatic collection and dilated small bowel loops, suggesting distal bowel perforation and meconium peritonitis.
  • The rectosigmoid was normal-sized, indicating a distal obstruction.
  • Postnatal examination confirmed distal ileal atresia type IIIa and bowel obstruction.

Conclusions:

  • Fetal MRI is a valuable tool for diagnosing ileal atresia with meconium peritonitis.
  • Accurate prenatal diagnosis facilitates appropriate neonatal management and surgical planning.
Keywords:
Ileal atresiafetal MRIfetal abdominal massesmeconium peritonitis

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