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2018-09-10  Case of the week # 479  © Fabien Ho  www.TheFetus.net

Answer to the case of the week # 479
September, 13, 2018 - September, 27, 2018

Dr Ho Fabien.1, Dr Abossolo T.2, Dr Cuillier F.2, Dr Fernandez C3

1. Radiology resident, Felix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France. 
2. Department of Gynecology and Obstetrics, Felix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France. 
3. Department of Pathology, Felix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France. 


Case report

A 27-year-old woman was referred to our hospital at 12 weeks of gestation. Her personal and familial history are non contributive, aneuploidy syndrome screening was normal. 
Our US examination revealed the following findings
 a peculiar abdominal wall defect: no omphalocele nor classical gastroschisis, but bowel herniation within umbilical cord in an extra-amniotic location. Bladder was never seen on repeated US examinations. Single umbilical artery was found.


Pathological macroscopical examination after abortion at 17 weeks of pregnancy revealed a male phenotype fetus without intra-abdominal bowel. Bowel was indeed found on the placental examination.

Other organs within the peritoneum and retroperitoneum, as well as fetal biometry, chest, limbs, head and neck anatomy were normal. Bladder was intraabdominal. Microscopical examination of the herniated bowel and other organs was normal. Both macroscopical and microscopical analysis of the placenta were otherwise non relevant.

This case encompasses the spectrum of Limb Body Wall Complex or Body Stalk Syndrome, since there is intimate relationship of the fetal herniated bowel within umbilical cord.

Images 1-7: 2D images of the fetus at 12 weeks of pregnancy showing bowel herniation within umbilical cord, absent bladder and single umbilical artery.

   



Videos 1-42D images of the fetus at 12 weeks of pregnancy showing bowel herniation within umbilical cord, absent bladder and single umbilical artery.

   

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