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Chinese Journal of Medical Ultrasound (Electronic Edition) ›› 2016, Vol. 13 ›› Issue (11): 840-844. doi: 10.3877/cma.j.issn.1672-6448.2016.11.009

Special Issue: Ultrasound medicine

• Obstetric and Gynecologic Ultrasound • Previous Articles     Next Articles

Ultrasonographic diagnosis of intestinal malrotation with midgut volvulus in fetus

Shuang Liu1, Qingqing Wu1,()   

  1. 1. Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
  • Received:2016-07-18 Online:2016-11-01 Published:2016-11-01
  • Contact: Qingqing Wu
  • About author:
    Correspending author: Wu Qingqing, Email:

Abstract:

Objective

To discuss the prenatal ultrasound manifestations of intestinalmalrotation with midgut volvulus.

Methods

An analysis of prenatal ultrasound findings and postnatal features was performed on five cases of fetuses with intestinal malrotation with midgut volvulus that were identified by ultrasonography at Beijing Obstetrics and Gynecology Hospital, in the period of January 2014 to May 2016.

Results

The 5 fetuses with intestinal malrotation with midgut volvulus were diagnosed based on the typical "whirlpoolsign" in ultrasonography. Indirect and non-specificultrasonographic signs included "coffee bean sign" , pseudocysts and ascites. Obstetric management and follow-up results: 2 cases emergency caesarian section were performed, infantstransferred to pediatric surgery, the intraoperative findings confirmed the prenatal diagnosis, postoperative the infants made an uneventful recovery. Another 3 cases suggesting the presence of meconium peritonitis, fetus born via a spontaneous vaginal delivery, the intraoperative findings confirmed the prenatal diagnosis, concurrent intestinal atresia, resectionof about 60 to 90 cm of atresia ileum, postoperative the infants showed symptoms of shortbowel syndrome.

Conclusions

Fetuses with intestinal malrotation with midgut volvulushad characteristic "whirlpool sign" in ultrasonography.Ultrasonography may be used as the first choice for prenatal diagnosis of this disease. Prenatal diagnosis of intestinal malrotation with midgut volvulus can provide guidance for clinical obstetrical management and postnatal treatment.

Key words: Ultrasonography, prenatal, Fetus, Congenital abnormalities, Intestinal volvulus

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