Prenatal Ultrasound Diagnosis and Clinical Prognosis of Fetal Intestinal Volvulus
10.13471/j.cnki.j.sun.yat-sen.univ(med.sci).2021.0415
- VernacularTitle:胎儿肠扭转的产前超声诊断及临床预后探讨
- Author:
Yun-xiang PAN
1
;
Qiu-ping MA
1
;
Dan CHEN
1
;
Song-xin WU
2
;
Li-min WANG
1
;
Ning SHANG
1
;
Shang-jie XIAO
3
;
Zhi-bin WAN
4
Author Information
1. Department of Ultrasound， Guangdong Women and Children Hospital， Guangzhou， 511400， China
2. Department of Radiology， Guangdong Women and Children Hospital， Guangzhou， 511400， China
3. Department of Neonatal Surgery， Guangdong Women and Children Hospital， Guangzhou， 511400， China
4. Department of Pathology， Guangdong Women and Children Hospital， Guangzhou， 511400， China
- Publication Type:Journal Article
- Keywords:
prenatal ultrasonography;
fetal;
congenital abnormalities;
intestinal volvulus
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(4):589-595
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the prenatal ultrasound manifestations of fetal intestinal volvulus， and to analyze the prognosis. MethodsPrenatal ultrasound features of 17 pregnant women with fetal intestinal volvulus confirmed by surgery and pathology at Guangdong Women and Children Hospital from June 2017 to March 2021 were analyzed retrospectively and the prognosis were followed up. ResultsThe ages of the subjects were 24 to 40 years old， with median age of 29（26~33） years old. Antepartum diagnosis found the gestational age was 24 to 33 weeks， with median gestational age of 26（24~31） weeks. Prenatal ultrasound found 17 cases had bowel obstruction， 16 cases showed a typical “whirlpool sign”， 13 cases showed twisting of mesenteric vessels， 2 cases showed coffee bean sign. Among the 17 cases， 10 cases were delivered and 7 cases were induced （including 2 cases of intrauterine fetal death）. Among 10 cases born， 9 cases of intestinal volvulus were confirmed by surgery （7 cases were accompanied by intestinal necrosis）， and 1 case of intestinal volvulus was healed spontaneously. Among the 7 cases of labor induction， autopsy in 2 cases confirmed intestinal volvulus， and the other 5 cases did not undergo autopsy. Among the 9 cases of intestinal volvulus， 7 cases recovered well after operation， and 2 cases died within a short period of time due to severe intestinal necrosis. In the 25 ultrasound examinations， the ultrasonographic patterns of intestinal volvulus in the 11 cases confirmed by surgery and pathology were dilated small intestine （22 times）， "whirlpool" signs （20 times）， clockwise wrapping of branch vessels of the superior mesenteric vein and the superior mesenteric artery （15 times）， and "coffee bean" sign （2 times）， ascites （6 times）， polyhydramnios （6 times）， pseudocysts（once）. All the 7 cases of intestinal necrosis appeared associated signs in the ultrasound examinations， including ascites （5 times）， the ambiguous intestine structure （once）， intestinal blood flow decreased or disappeared （twice）， the intestinal dilatation decreased （once）， "coffee bean" sign （twice）. ConclusionsMost fetal intestinal volvulus has characteristic sonographic features. Prenatal ultrasound has important application value in the diagnosis and monitoring of intestinal volvulus，which could provide important information for prenatal consultation and clinical treatment.
