Hudson Kayla, Birkemeier Krista L, Stagg Hayden, Allen Steven R
College of Medicine, Texas A&M Health Science Center, Temple, Texas.
Department of Radiology, Baylor Scott & White Medical Center, Temple, Texas.
Proc (Bayl Univ Med Cent). 2021 Jul 23;34(6):691-692. doi: 10.1080/08998280.2021.1941686. eCollection 2021.
We report a rare case of gastroschisis with extracorporeal liver suspected on late first trimester ultrasound and confirmed with second trimester ultrasound and magnetic resonance imaging in one fetus in a twin pregnancy. Liver herniation is common in omphalocele, a membrane-covered abdominal wall defect associated with other congenital anomalies. However, it is highly uncommon in gastroschisis, an uncovered abdominal wall defect aside of the cord insertion. Presence of liver herniation complicates prenatal differentiation between omphalocele and gastroschisis. The twins were born at 31 weeks' gestation due to preterm labor. The baby was treated with a silo device, followed by biologic mesh and a wound vac with instillation of fluid to prevent desiccation. Ultimately, the baby died of sepsis, with multiorgan failure and polymicrobial infection.
我们报告了一例罕见的双胎妊娠中一个胎儿的腹裂合并体外肝脏的病例，该病例在孕早期超声检查时疑似，孕中期超声检查及磁共振成像确诊。肝脏疝出在脐膨出中很常见，脐膨出是一种与其他先天性异常相关的有膜覆盖的腹壁缺损。然而，在腹裂中极为罕见，腹裂是脐带插入处以外的无覆盖的腹壁缺损。肝脏疝出的存在使产前区分脐膨出和腹裂变得复杂。这对双胞胎因早产于孕31周出生。该婴儿接受了袋状装置治疗，随后使用生物补片和伤口负压吸引并注入液体以防止干燥。最终，婴儿死于败血症、多器官功能衰竭和多种微生物感染。
