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Early sonographic detection of fetal intestinal obstruction and possible diagnostic pitfalls
1Department of Obstetrics and Gynecology, Rambam Medical Center, Technion Faculty of Medicine, Haifa, Israel.
Insights
Prenatal ultrasound may show intestinal obstruction in fetuses with volvulus or anal atresia. Sonographers should distinguish this from normal transient intestinal dilation in early pregnancy to avoid misdiagnosis.
Area of Science:
- Medical Imaging
- Fetal Medicine
- Pediatric Surgery
Background:
- Intestinal obstruction is a serious condition in newborns.
- Prenatal diagnosis aims to identify fetal anomalies early.
- Sonography is crucial for evaluating fetal gastrointestinal tract development.
Observation:
- Five fetuses between 15-17 weeks' gestation presented with sonographic findings suggestive of intestinal obstruction.
- Dilation of the fetal intestine was the primary sonographic indicator.
- Two cases involved additional congenital abnormalities.
Findings:
- The observed intestinal dilation was associated with volvulus and/or anal atresia in the affected fetuses.
- Transient, physiological intestinal dilation due to normal peristalsis can mimic obstruction in early gestation.
- Careful sonographic assessment is needed to differentiate pathological obstruction from normal physiological changes.
Implications:
- Accurate prenatal diagnosis of fetal intestinal obstruction is critical for timely surgical planning and management.
- Awareness of physiological intestinal dilation can prevent false-positive diagnoses of obstruction.
- Improved sonographic interpretation aids in better perinatal care for gastrointestinal anomalies.
Abstract:
We present five fetuses at 15-17 weeks' gestation with a sonographic diagnosis of intestinal obstruction. Dilation of the intestine was the presenting sonographic finding in fetuses with a volvulus and/or anal atresia. Two of the fetuses also had other abnormalities. Intestinal peristalsis may be observed in early pregnancy as transient dilation of intestinal segments. Sonographers are cautioned about a false-positive diagnosis of intestinal obstruction in such cases.