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[Prenatal diagnosis of a small intestinal volvulus]
J J Terzibachian1, J D Shu, G Levy
1Service de Gynécologie-Obstétrique, CHG, BP 499, Belfort.
Summary
Jejunal atresia, a common cause of neonatal bowel obstruction, can lead to volvulus. Early diagnosis via ultrasound in this case prevented serious complications like meconial peritonitis.
Area of Science:
- Neonatal surgery
- Fetal medicine
- Pediatric gastroenterology
Background:
- Jejuno-ileal obstructions account for 95% of neonatal bowel atresia cases.
- The incidence of jejuno-ileal atresia ranges from 1 in 3,000 to 1 in 5,000 live births.
- Small bowel volvulus is a rare but serious complication of jejunal atresia.
Purpose of the Study:
- To report a case of small bowel volvulus secondary to jejunal atresia.
- To highlight the importance of prenatal diagnosis in managing fetal gastrointestinal anomalies.
- To emphasize the successful outcome achieved through timely intervention.
Main Methods:
- A case of jejunal atresia with secondary volvulus was diagnosed at 35 weeks gestation.
- Ultrasound examination was performed due to decreased fetal movement perception.
- Fetal extraction was performed before the development of perforation and meconial peritonitis.
Main Results:
- Successful diagnosis of small bowel volvulus secondary to jejunal atresia.
- Timely fetal extraction prevented catastrophic complications.
- The neonate was delivered without perforation or meconial peritonitis.
Conclusions:
- Prenatal diagnosis of jejunal atresia and associated volvulus is crucial.
- Prompt surgical intervention in utero or immediately after birth can significantly improve outcomes.
- This case underscores the effectiveness of ultrasound in identifying fetal gastrointestinal emergencies.