Aviram R, Erez I, Dolfin T Z, Katz S, Beyth Y, Tepper R
Department of Obstetrics and Gynecology, Sapir Medical Center, Kfar Saba, Israel.
J Clin Ultrasound. 1998 Feb;26(2):106-8. doi: 10.1002/(sici)1097-0096(199802)26:2<106::aid-jcu11>3.0.co;2-k.
The sonographic findings in a fatal case of congenital short-bowel syndrome are reported. Sonography at 11 weeks of gestation showed a 11 x 6 mm hyperechoic mass interpreted to be a midgut umbilical hernia. A repeat scan 2 weeks later showed an intact anterior abdominal wall, no umbilical herniation, and appropriate fetal growth. Forty-eight hours after full-term, vaginal delivery, the infant began vomiting bile and passing blood rectally. Imaging studies showed distended bowel loops without air-fluid levels and incomplete bowel obstruction. Laparotomy showed malrotation and short small bowel without volvulus. The infant died at 9 weeks of age. When delayed return of the midgut to the abdominal cavity is noted on prenatal sonograms, follow-up sonograms should be done throughout the second trimester, especially in patients with a family history of short-bowel syndrome, to search for dilated short bowel loops. If such loops are found, patients should be given options for pregnancy termination.
报道了一例先天性短肠综合征致死病例的超声检查结果。妊娠11周时的超声检查显示一个11×6毫米的高回声团块，被解释为中肠脐疝。两周后复查显示前腹壁完整，无脐疝，胎儿生长正常。足月阴道分娩48小时后，婴儿开始呕吐胆汁并经直肠排血。影像学检查显示肠袢扩张但无气液平面，存在不完全性肠梗阻。剖腹探查显示肠旋转不良和小肠短小但无肠扭转。婴儿在9周龄时死亡。当产前超声检查发现中肠延迟回纳入腹腔时，应在整个孕中期进行超声随访，尤其是有短肠综合征家族史的患者，以寻找扩张的短肠袢。如果发现此类肠袢，应向患者提供终止妊娠的选择。
