Sherer David M, Catala Natalia, Ebner Megan, Walters Erin, Kheyman Mila, Zinn Harry, Dalloul Mudar
The Division of Maternal Fetal Medicine, The Department of Obstetrics and Gynecology, and the Department of Radiology State University of New York (SUNY), Downstate Health Sciences University, Brooklyn, NY, USA.
Radiol Case Rep. 2024 Feb 14;19(5):1753-1757. doi: 10.1016/j.radcr.2024.01.069. eCollection 2024 May.
Etiologies underlying the relatively infrequent third-trimester sonographic depiction of dilated fetal bowel include (functional or mechanical) bowel obstruction, intestinal atresia, volvulus, annular pancreas, intestinal malrotation, intussusception, gastrointestinal duplications, cystic fibrosis-associated meconium ileus, congenital chloride diarrhea, microvillus inclusion disease, intestinal neuronal dysplasia, and meconium plug syndrome. Fetal bowel obstruction may be associated with aneuploidy (mostly Trisomy 21 in association with esophageal or duodenal atresia), and rarely select microduplications or deletions. We present unusual sonographic findings associated with transient marked proximal fetal bowel dilatation in association with concurrent development of oligohydramnios, in a growth-restricted fetus at 35 weeks' gestation. This case supports that upon observation of dilated loops of fetal bowel, while not negating the potential need for delivery secondary to potential bowel compromise, consideration should be given for observation in anticipation of potential spontaneous resolution of this condition, especially among growth-restricted fetuses with decreased amniotic fluid volume in prematurity.
孕晚期超声检查较少发现胎儿肠道扩张的潜在病因包括（功能性或机械性）肠梗阻、肠道闭锁、肠扭转、环状胰腺、肠旋转不良、肠套叠、胃肠道重复畸形、囊性纤维化相关胎粪性肠梗阻、先天性氯腹泻、微绒毛包涵体病、肠道神经元发育异常和胎粪堵塞综合征。胎儿肠梗阻可能与非整倍体有关（主要是21三体综合征伴食管或十二指肠闭锁），很少与特定的微重复或缺失有关。我们报告了一例孕35周生长受限胎儿的超声检查异常发现，该胎儿出现短暂性明显的近端胎儿肠道扩张，并伴有羊水过少的同时发生。该病例支持，在观察到胎儿肠道扩张时，虽然不能排除因潜在的肠道损害而可能需要分娩的情况，但应考虑进行观察，以期这种情况可能自发缓解，尤其是在早产且羊水过少的生长受限胎儿中。
