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2011-02-01-12 Answer to the case of the week #289 © Sosa Olavarria

Answer to the case of the week #289

March 17, 2011 - March 31, 2011.

Alberto Sosa Olavarria, MD.

CEUSP. Valencia. Venezuela.

Case report

This is a case of a patient who was scanned at 20 weeks of gestation. Patient had non-contributive family and personal history and her pregnancy was uneventful. There were no anomalies detected on the ultrasound except of the echoic protrusion attached to the caudal region resembling a tail. The finding changed during the time, after 2 minutes of ultrasound observation, the protrusion dettached from th caudal region and was floating in the amniotic fluid near the buttocks. The diagnosis was a physiological process of fetal defecation and the tail-like protrusion was a fetal stool.

Images 1- 4
: Images showing caudal region, note an echoic, tail-like protrusion which seems to be attached to the anal region. This protrusion is a meconium attached to the anus.

Images 5
: This image shows that the meconium is not attached to the anus anymore. The meconium is visible by the buttocks (arrow).

Videos 1,2
: Videos showing the fetus passing meconium.

Videos 3,4
: Videos 3 shows meconium still attached to the anus. Video 4 shows the complited defecation, the stool is not attached to the anus, but floating next to the buttocks.

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