Lyttle Bailey D, Liechty Kenneth, Corkum Kristine, Galan Henry, Behrendt Nicholas, Zaretsky Michael, Bruny Jennifer, Derderian S Christopher
Department of General Surgery, University of Colorado, Denver, CO, USA.
Department of Pediatric Surgery, Children's Hospital Colorado, Denver, CO, USA.
J Surg Case Rep. 2021 Dec 28;2021(12):rjab551. doi: 10.1093/jscr/rjab551. eCollection 2021 Dec.
We present a case in which prenatal imaging at 21-weeks' gestation suggested duodenal atresia with a double-bubble sign and enlarged stomach. Fetal magnetic resonance imaging findings demonstrated dilation of the stomach and proximal duodenum favoring duodenal atresia but no indications of esophageal atresia. Subsequent prenatal imaging demonstrated interval spontaneous decompression of the stomach without the development of polyhydramnios, obscuring the diagnosis. Postnatally, initial abdominal radiography showed a gasless abdomen, and an oral gastric tube could not pass the mid-esophagus, raising concern for pure esophageal atresia. Intraoperative findings were consistent with duodenal atresia, pure esophageal atresia and a gastric perforation due to a closed obstruction. In this case report, we review the prenatal diagnostic challenges and the limited literature pertaining to this unique pathology.
我们报告一例病例，孕21周时的产前影像检查提示十二指肠闭锁，伴有双泡征和胃扩大。胎儿磁共振成像结果显示胃和十二指肠近端扩张，支持十二指肠闭锁，但无食管闭锁迹象。随后的产前影像检查显示胃间歇性自发减压，未出现羊水过多，使诊断变得模糊。出生后，最初的腹部X线平片显示无气腹，口服胃管无法通过食管中段，引发了对单纯食管闭锁的担忧。术中发现与十二指肠闭锁、单纯食管闭锁以及因闭锁性梗阻导致的胃穿孔相符。在本病例报告中，我们回顾了产前诊断的挑战以及与这种独特病理相关的有限文献。
