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[Abnormalities of the upper gastrointestinal tract diagnosed prenatally by ultrasound]
Insights
Prenatal diagnosis of upper intestinal atresias, such as esophageal atresia, improves infant outcomes. Early detection via ultrasound enables timely surgical intervention for better prognoses.
Area of Science:
- Medical Science
- Pediatric Surgery
- Prenatal Diagnosis
Background:
- Hydramnion in late pregnancy can indicate upper intestinal atresias.
- Esophageal atresia occurs in approximately 1 in 2,500 births, often with co-occurring malformations.
Observation:
- Characteristic sonographic findings for esophageal atresia include hydramnion and absent stomach visualization.
- Duodenal atresia diagnosis involves identifying an overfilled stomach and fluid-filled proximal small intestine on ultrasound.
Findings:
- Prenatal diagnosis of these atresias is crucial for improving patient prognosis.
- Optimal collaboration between obstetricians and pediatric surgeons is key for successful management.
- The presented cases highlight successful surgical outcomes following prompt intervention after birth.
Implications:
- Early prenatal detection of intestinal atresias significantly enhances surgical planning and outcomes.
- Improved diagnostic accuracy in prenatal sonography aids in identifying critical congenital anomalies.
- Multidisciplinary care involving obstetrics and pediatric surgery is vital for managing neonates with gastrointestinal malformations.
Abstract:
A hydramnion occurring during the second half of pregnancy may be due to atresias in the upper intestinal tract. Generally, one case of oesophageal atresia is likely to occur in every 2,500 births, often together with other malformations. Prenatal diagnosis of such atresias substantially improves prognosis for these children via optimal cooperation between the obstetrician and the paediatric surgeon. Characteristic features of oesophageal atresia in the sonographic image are, besides the hydramnion, the absence of visualisation of the stomach. Sonographic diagnosis of duodenal atresias is based on visualisation of the stomach, which is excessively filled with fluid, and of the portion of the small intestine located cranially of the stenosis. The patients treated by the author and presented here were successfully operated on via termination of birth and immediate surgery by the paediatric surgeon.