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Analysis of Ileal Atresia from Prenatal Ultrasound to Postoperative Follow-up: Two Case Reports
Zimeng Lv1,2, Hongyi Qu3, Jingyuan Hu1,2
1Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Abdominal Medical Imaging, Jinan, Shandong Province, China.
Insights
Congenital ileal atresia, a common cause of intestinal obstruction in newborns, presents challenges in prenatal diagnosis. Early ultrasound detection aids in surgical planning and improves prognosis for affected infants.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Fetal medicine
Background:
- Congenital ileal atresia is a frequent neonatal intestinal malformation causing obstruction.
- It manifests with symptoms like abdominal distension and vomiting, potentially life-threatening.
- Prenatal ultrasound is crucial for diagnosing this condition and guiding postnatal surgical intervention.
Observation:
- Two cases of congenital ileal atresia presented with fetal intestinal dilation and polyhydramnios on ultrasound.
- Both newborns underwent successful surgical correction.
- Subtyping based on intraoperative findings revealed varied prognoses despite similar initial ultrasound presentations.
Findings:
- Prenatal ultrasound, while challenging for precise localization and classification, is vital for assessing disease progression.
- Ultrasound findings, including fetal intestinal dilation, can indicate ileal atresia.
- Varied ultrasound manifestations can correlate with different intraoperative findings and patient outcomes.
Implications:
- Accurate prenatal ultrasound diagnosis of ileal atresia aids in gestational assessment and surgical planning.
- Further research into identifying specific ultrasound markers for lesion location is essential.
- Improved prenatal detection and classification can optimize management strategies and patient prognoses.
Background:
Congenital ileal atresia is a rare neonatal disease, the most common type of intestinal malformation in newborns, and one of the most common causes of congenital intestinal obstruction. It can cause various digestive system symptoms, including abdominal distension, vomiting, abnormal bowel movements, etc. In severe cases, it can be life-threatening. A prenatal ultrasound examination can assist clinical diagnosis of congenital ileal atresia, and those with a clear prenatal diagnosis should undergo surgical treatment after birth.
Case Presentation:
We have, herein, reported two cases of congenital ileal atresia, both of which showed fetal intestinal dilation (>7mm) and excessive amniotic fluid on prenatal ultrasound. Both newborns underwent surgical treatment after delivery and were confirmed to have congenital ileal atresia during surgery. Due to the different prenatal ultrasound manifestations of the two patients, they were divided into two different subtypes based on intraoperative manifestations. We observed significant differences in the prognosis of the two patients after surgery.
Conclusion:
Accurately locating and classifying ileal atresia using prenatal ultrasound is challenging; however, it plays an effective role in disease progression, gestational assessment, and prognosis. Accurately identifying intestinal diseases and/or the location of lesion sites through direct and indirect ultrasound findings in the fetal abdominal cavity is an important research direction for prenatal ultrasound.
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