Department of Obstetrics and Gynecology, Specialized Clinical Sciences, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2021 Jul 20;46(2):101-104.
Thus far, few reports have described the rare, non-obstructive type of fetal diffuse bowel dilatation. We describe such a case in the fetus of a 31-year-old Pakistani pregnant woman, gravida 3, para 2. A series of ultrasonographic examinations in the third trimester showed a "honeycomb" appearance of fetal d iffuse dilated bowel loops, a mildly enlarged stomach, and mild polyhydramnios. Magnetic resonance imaging further revealed fluid-filled dilated bowel loops extending to the colon and rectum. The male neonate was born at 36 weeks and had marked abdominal distension but did not show signs of mechanical bowel obstruction. He passed a profuse amount of liquid with meconium at 4 h of life. Thereafter, his distended abdomen and bowel dilatation subsided, and he became asymptomatic within a week of life. Taken together with previous case reports, among infants who show the "honeycomb" sign in utero, there definitely exists a subset with a favorable outcome and an unknown etiology. This case alerts physicians who are responsible for perinatal care to the fact that careful assessment is required for a newborn when the "honeycomb" sign is observed via fetal imaging. Without evidence of mechanical bowel obstruction, alternative etiologies should be sought to avoid unnecessary laparotomy.
到目前为止，很少有报道描述罕见的非梗阻性胎儿弥漫性肠扩张类型。我们描述了一名 31 岁的巴基斯坦孕妇胎儿的这种情况，她是第三次怀孕，第二次分娩。在妊娠晚期的一系列超声检查中，胎儿弥漫性扩张的肠袢呈“蜂窝状”，胃轻度增大，羊水轻度过多。磁共振成像进一步显示充满液体的扩张肠袢延伸至结肠和直肠。男婴于 36 周时出生，腹部明显膨隆，但没有机械性肠梗阻的迹象。他在出生后 4 小时排出大量混有胎粪的液体。此后，他的腹胀和肠扩张缓解，在出生后一周内无症状。结合以往的病例报告，在宫内表现出“蜂窝状”征象的婴儿中，确实存在一部分具有良好结局和未知病因的婴儿。这个病例提醒负责围产期护理的医生，当通过胎儿影像学观察到“蜂窝状”征象时，需要对新生儿进行仔细评估。如果没有机械性肠梗阻的证据，应寻找其他病因，以避免不必要的剖腹手术。
