Fetal intestinal volvulus: a clinico‐sonographic finding

Uerpairojkit, Boonchai; Charoenvidhya, Dhiraphongs; Tanawattanacharoen, Somchai; Manotaya, Saknan; Wacharaprechanont, Teera; Tannirandorn, Yuen

doi:10.1046/j.1469-0705.2001.00425.x

Cited by 21 publications

(36 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Among 13 cases, eight (61.5%) mothers reported a reduction in these movements. Because this sign is very unspecific and difficult to quantity or identify objectively, depending as it does on the mother's personal evaluation, it is rarely mentioned in the literature . However, in our case series, more than 50% of patients in this situation reported a decrease in fetal movements, which doesn't seems to be accidental.…”

Section: Discussionsupporting

confidence: 82%

“…Decreased active fetal movements in the literature. 13,14 However, in our case series, more than 50% of patients in this situation reported a decrease in fetal movements, which doesn't seems to be accidental. It appears that at the moment of the volvulus and/or the secondary intestinal perforation, the fetus, stunned by the pain, limits its movements.…”

Section: Resultsmentioning

confidence: 47%

See 1 more Smart Citation

Prenatal diagnosis of antenatal midgut volvulus: Specific ultrasound features

et al. 2018

View full text Add to dashboard Cite

Objective To assess specific, direct, and indirect prenatal ultrasound features in cases of fetal midgut volvulus. Methods Retrospective case series of neonatal volvulus, based on postnatal and prenatal imaging findings that occurred from 2006–2017. Prenatal and postnatal signs including the specific “whirlpool sign” were computed. Postnatal volvulus was confirmed by pathology examination after surgery or neonatal autopsy. Results Thirteen cases of midgut volvulus were identified. Though not a specific sign, a decrease in active fetal movements was reported in eight patients (61.5%). The prenatal whirlpool sign was directly seen in 10 cases, while an indirect but suggestive sign, a fluid‐filled level within the dilated loops, was present in five cases. No intestinal malrotation was observed. Pregnancy outcomes were two terminations of pregnancy, both associated with cystic fibrosis, one early neonatal death, three prenatal spontaneous regressions, and seven favorable outcomes after neonatal surgery with resection of midgut atresia. Conclusions Identification of the whirlpool sign or of a fluid‐filled level within the dilated loops improves the accuracy of ultrasound findings for suspected volvulus. In the absence of total volvulus (in cases of intestinal malrotation) or association with cystic fibrosis, the prognosis appears good.

show abstract

Section: Discussionsupporting

confidence: 82%

Section: Resultsmentioning

confidence: 47%

Prenatal diagnosis of antenatal midgut volvulus: Specific ultrasound features

et al. 2018

View full text Add to dashboard Cite

show abstract

“…[25][26][27] In all 3, the twisted bowel was directly observed on gray scale sonography and was characteristic of intestinal volvulus, but no diagnostic Doppler features were reported. However, in our case, the vascular whirlpool sign made the diagnosis, whereas the B-mode sonographic appearance was nontypical.…”

mentioning

confidence: 99%

Prenatal Diagnosis of Small-Bowel Volvulus Using 3-Dimensional Doppler Sonography

Sammour

Leibovitz

Degani

et al. 2008

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

olvulus is generally a condition that occurs in the pediatric age group, commonly associated with intestinal malrotation. The intrauterine occurrence of this condition is a rare occasion, and only a few cases have been reported. Precise diagnosis is hampered by the extensive differential diagnoses of fetal intra-abdominal masses observed during sonographic examination. However, detection of the "whirlpool sign" facilitates sonographic diagnosis of this condition. We report a case of intestinal volvulus that occurred in utero diagnosed definitively with 2-dimensional and 3-dimensional (3D) Doppler sonography. To our knowledge, there is no previous report of such a case that was diagnosed by 3D Doppler sonography in the English literature. Case ReportA 50-year-old nulliparous woman was admitted to our maternity ward at 28 gestational weeks after decreased fetal movements. Her pregnancy was achieved with ovum donation and in vitro fertilization. She had 1 previous pregnancy that ended with a spontaneous miscarriage. Her medical history was unremarkable. Her routine follow-up results were normal during this pregnancy, including a fetal anatomic scan that was performed 3 weeks earlier.Initial evaluation revealed a nonstress test result of a reassuring fetal heart rate pattern and no uterine contractions. On fetal sonography, a singleton fetus was observed with a normal amniotic fluid index and no ascites or intraperitoneal echogenicity. However, a dilated stomach was seen, together with a fixed, dilated, Cshaped bowel loop in the upper part of the abdominal cavity (Figure 1). The affected bowel had a thick echogenic

show abstract

“…Differentiation of volvulus from a duplication cyst and meconium pseudocyst may be of utmost importance because of the life-threatening complications of the former pathology. Imaging findings for malrotation and volvulus included midline stomach, small bowel on right side of the midline, classic mesenteric whirlpool sign (twisted mesentery around the mesenteric vascular stalk), coffee-bean sign, and three parallel fixed bowel loops on transverse scan (4,(6)(7)(8). Reported imaging findings for intestinal duplication cyst included thin-or thick-walled cystic structure, double wall appearance/sign, pseudo-double bubble appearance, abdominal cyst with peristalsis, echogenic mesenteric tissue consisting of fat close to the cyst, and intra-cystic echogenic contents (9)(10)(11)(12).…”

Section: Answermentioning

confidence: 99%

What is your diagnosis?

Başaran¹,

Başaran²

2016

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

A 20-year-old primigravida was referred due to increased risk of trisomy 21 in the triple test result at 21 weeks of gestation, which was 1/59. Sonographic examination revealed hypoplastic nasal bone (NB=4.3 mm) and hyperechogenic bowel with mildly dilated segments (bowel diameter=4.5 mm) (Figure 1). Past medical histories of both parents were insignificant. There was no consanguineous marriage. Amniocentesis was performed. Quantitative fluorescence polymerase chain reaction (PCR), karyotype, and cystic fibrosis panel were normal. Due to hyperechogenic bowel and mildly dilated segments of the bowel, close surveillance was planned. At 24 weeks and 25 weeks, these segments of the bowel continued to dilate and increased to 9.8 mm and 11.2 mm, respectively. At 25 weeks of gestation, anorectal complex was observed intact. Dilatation of the bowel progressed and reached to 23.8 mm at 29 weeks of gestation, which was also coincided with an increase in the amount of amniotic fluid (Figure 2). Besides dilated bowel segments, a cystic structure with hyperechogenic inner fluid than the other dilated bowel segments had become noticeable during the examination at 29 weeks. Due to the risk of volvulus, weekly follow-up visits were scheduled. From 29 to 37 weeks, the size of the cyst and amount of amniotic fluid continued to increase, although the diameter of the dilated bowel remained relatively stable (Figure 3). Within last 4 weeks before delivery, in addition to the cyst and bowel dilatation, ascites began to accumulate in the fetal abdomen. In this period, Doppler of the middle cerebral artery and umbilical artery remained normal, however a-waves in the ductus venosus started to deepen and fetal ascites progressively increased. We, therefore, decided to perform paracentesis via ex utero intrapartum treatment (EXIT) procedure in the intrapartum period. At 37 weeks, planned cesarean under deep general anesthesia was performed. Male infant weighing 2910 g was delivered. Umbilical cord was not clamped, and oxytocin administration was withheld. Newborn was laid between the mothers legs. Under the ultrasound guidance, paracentesis was performed and 240 mL of green fluid was aspirated, which effectively ruled out hemorrhagic ascites. The newborn was neither intubated nor required mechanical ventilation, and after a brief stay in the neonatal intensive care unit, he was operated. After an uneventful postoperative course, he was discharged. At 2 years of age, he was faring well.

show abstract

Fetal intestinal volvulus: a clinico‐sonographic finding

Cited by 21 publications

References 9 publications

Prenatal diagnosis of antenatal midgut volvulus: Specific ultrasound features

Prenatal diagnosis of antenatal midgut volvulus: Specific ultrasound features

Prenatal Diagnosis of Small-Bowel Volvulus Using 3-Dimensional Doppler Sonography

What is your diagnosis?

Contact Info

Product

Resources

About