Cserni G, Tankó A
Bács-Kiskun Megyei Onkományzat Kórháza, Kecskemét, Patológiai Osztály.
Orv Hetil. 1997 Apr 13;138(15):931-7.
Anterior abdominal wall defects are not too rare between developmental abnormalities. A case of abdominal wall defect associated with complex malformations diagnosed prenatally is reported in the paper. In the present case of limb-body wall complex a right sided abdominoschisis was associated with rotational abnormality of the lower limbs, clubfoot, scoliosis, meningomyelocele, lack of developed pelvic organs, consecutive dilatation of the upper urinary tract, anal atresia, lack of external genitalia, lack of diaphragm and hypoplastic lungs. Review of the pertinent literature has revealed over 100 cases that clearly indicate the possible phenotypic variation of the limb-body wall complex. These data add further evidence to support the existence of two different phenotypes and possibly pathogenesis under the heading of limb-body wall complex. The three principal theories on the possible aetiology of the complex are also discussed. Because the limb-body wall complex is incompatible with life, it is important to diagnose the lesions prenatally, and to differentiate them from other anterior abdominal wall defects. Serum alpha-fetoprotein measurement, and ultrasonographic examination are the key to prenatal diagnosis.
在发育异常中,前腹壁缺损并非十分罕见。本文报道了一例产前诊断出的与复杂畸形相关的腹壁缺损病例。在本例肢体 - 体壁复合体病例中,右侧腹裂与下肢旋转异常、马蹄内翻足、脊柱侧弯、脊髓脊膜膨出、盆腔器官发育不全、上尿路持续性扩张、肛门闭锁、外生殖器缺如、膈肌缺如及肺发育不全相关。对相关文献的回顾显示,有100多例病例清楚地表明了肢体 - 体壁复合体可能的表型变异。这些数据进一步证明了在肢体 - 体壁复合体这一类别下存在两种不同表型以及可能的发病机制。文中还讨论了关于该复合体可能病因的三种主要理论。由于肢体 - 体壁复合体与生命不相容,因此产前诊断这些病变并将其与其他前腹壁缺损区分开来很重要。血清甲胎蛋白测定和超声检查是产前诊断的关键。