In-utero gastric perforation from combined duodenal and esophageal atresia without consistent polyhydramnios.

Autor: Lyttle BD; Department of General Surgery, University of Colorado, Denver, CO, USA., Liechty K; Department of Pediatric Surgery, Children's Hospital Colorado, Denver, CO, USA., Corkum K; Department of Pediatric Surgery, Children's Hospital Colorado, Denver, CO, USA., Galan H; Department of Maternal-Fetal Medicine, Children's Hospital Colorado, Denver, CO, USA., Behrendt N; Department of Maternal-Fetal Medicine, Children's Hospital Colorado, Denver, CO, USA., Zaretsky M; Department of Maternal-Fetal Medicine, Children's Hospital Colorado, Denver, CO, USA., Bruny J; Department of Pediatric Surgery, Children's Hospital Colorado, Denver, CO, USA., Derderian SC; Department of Pediatric Surgery, Children's Hospital Colorado, Denver, CO, USA.
Jazyk: angličtina
Zdroj: Journal of surgical case reports [J Surg Case Rep] 2021 Dec 28; Vol. 2021 (12), pp. rjab551. Date of Electronic Publication: 2021 Dec 28 (Print Publication: 2021).
DOI: 10.1093/jscr/rjab551
Abstrakt: We present a case in which prenatal imaging at 21-weeks' gestation suggested duodenal atresia with a double-bubble sign and enlarged stomach. Fetal magnetic resonance imaging findings demonstrated dilation of the stomach and proximal duodenum favoring duodenal atresia but no indications of esophageal atresia. Subsequent prenatal imaging demonstrated interval spontaneous decompression of the stomach without the development of polyhydramnios, obscuring the diagnosis. Postnatally, initial abdominal radiography showed a gasless abdomen, and an oral gastric tube could not pass the mid-esophagus, raising concern for pure esophageal atresia. Intraoperative findings were consistent with duodenal atresia, pure esophageal atresia and a gastric perforation due to a closed obstruction. In this case report, we review the prenatal diagnostic challenges and the limited literature pertaining to this unique pathology.
(Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2021.)
Databáze: MEDLINE
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