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2015-03-01-08 Case of the week #391 © Grochal www.TheFetus.net


Answer to the case of the week #391

March 26, 2015 - April 09, 2015

Frantisek Grochal, MD1
Vladimír Bohmer, MD2; Elena Skladaná, MD3.

1. Femicare, Center of prenatal ultrasonographic diagnostics, Martin, Slovak republic. Catholic University in Ruzomberok, Faculty of Health Care, Ruzomberok, Slovak Republic;
2. Head of the Gynecological and obstetrical department, Poprad Hospital, Poprad, Slovak Republic;
3. Pathological department, Poprad Hospital, Poprad, Slovak republic.



Case report

22-year-old G1P0 was sent to our unit at 22 weeks due to abnormal hypoechoic structure within fetal abdomen. Our ultrasonographic examination revealed following findings:

- fetal bradycardia 59-75 beats per minute;
- dilated and twisted midgut loop with twisted mesenteric vessels (depicted by color Doppler and 3D/4D Doppler techniques).

The findings were suspected of midgut volvulus. The parents opted for the termination of the pregnancy and following pathological study has confirmed the findings.

Images 1, 2, and video 1: The images and video demonstrate fetal bradycardia detected at the level of the middle cerebral artery (image 1), umbilical artery (image 2), and four chamber view of the heart (video 1).

 



Images 3, 4, and video 2: The images show normal size and position of the fetal stomach (image 3, video 2) and normal appearance of the fetal kidneys (image 4).

 



Images 5, 6: The images demonstrate dilated loop of fetal bowel.

 

Images 7, 8: The images show coronal 2D and 3D scan of the fetal abdomen with twisted dilated loop of bowels representing midgut volvulus.

 

Videos 3, 4, 5, and 6: 22 weeks - midgut volvulus of the fetus; the videos show dilated and twisted bowel loops with twisted vessels inside the loop.

 

 

Images 9, 10, 11: 22 weeks - midgut volvulus of the fetus; the images show 3D scans of the dilated and twisted bowel loops (white arrows on the images 10) with twisted mesenterial vessels (green arrows on the image 10).

 



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