open access
Evaluation of ultrasonography in fetal intestinal malrotation with midgut volvulus
Affiliations- Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China, China
open access
Abstract
Objectives: To investigate the clinical significance of prenatal diagnosis and prognostic evaluation of fetal intestinal malrotation with midgut volvulus via ultrasonography.
Material and methods: Ultrasonographic findings and clinical outcomes of fetal intestinal malrotation with midgut volvulus prenatally diagnosed via ultrasound at the Zhangzhou Hospital Affiliated of Fujian Medical University from January 2013 to May 2020 were summarised and analyzed.
Results: Eleven cases of fetal intestinal malrotation with midgut volvulus were accurately prenatally diagnosed according to the specific ultrasound signs, such as ‘whirlpool sign’ and ‘twining sign’. Indirect and nonspecific ultrasonographic signs included ascites in four cases and echogenic bowel in nine, all of which were accompanied by intestinal dilatation at various degrees. Among all cases, two were complicated with other system abnormalities, and one had a chromosome abnormality. Three pregnant women chose termination of pregnancy, and eight neonates were transferred to the pediatric department for surgery after obtaining written informed consent. An accurate prenatal diagnosis was confirmed postoperatively, and the fetus recovered well postoperatively.
Conclusions: Fetal intestinal malrotation with midgut volvulus has typical sonographic features, and ultrasonography is the method of choice for prenatal diagnosis of this disease. Fetal intestinal malrotation with midgut volvulus is a non-fatal congenital malformation that can be treated. Prenatal diagnosis is essential for early postnatal treatment, and early surgery can often obtain good efficacy and prognosis.
Abstract
Objectives: To investigate the clinical significance of prenatal diagnosis and prognostic evaluation of fetal intestinal malrotation with midgut volvulus via ultrasonography.
Material and methods: Ultrasonographic findings and clinical outcomes of fetal intestinal malrotation with midgut volvulus prenatally diagnosed via ultrasound at the Zhangzhou Hospital Affiliated of Fujian Medical University from January 2013 to May 2020 were summarised and analyzed.
Results: Eleven cases of fetal intestinal malrotation with midgut volvulus were accurately prenatally diagnosed according to the specific ultrasound signs, such as ‘whirlpool sign’ and ‘twining sign’. Indirect and nonspecific ultrasonographic signs included ascites in four cases and echogenic bowel in nine, all of which were accompanied by intestinal dilatation at various degrees. Among all cases, two were complicated with other system abnormalities, and one had a chromosome abnormality. Three pregnant women chose termination of pregnancy, and eight neonates were transferred to the pediatric department for surgery after obtaining written informed consent. An accurate prenatal diagnosis was confirmed postoperatively, and the fetus recovered well postoperatively.
Conclusions: Fetal intestinal malrotation with midgut volvulus has typical sonographic features, and ultrasonography is the method of choice for prenatal diagnosis of this disease. Fetal intestinal malrotation with midgut volvulus is a non-fatal congenital malformation that can be treated. Prenatal diagnosis is essential for early postnatal treatment, and early surgery can often obtain good efficacy and prognosis.
Keywords
ultrasonography; prenatal; whirlpool sign; intestinal malrotation; midgut volvulus
About this articleTitle
Evaluation of ultrasonography in fetal intestinal malrotation with midgut volvulus
Journal
Issue
Article type
Research paper
Pages
296-301
Published online
2022-02-10
Page views
5157
Article views/downloads
1220
DOI
Pubmed
Bibliographic record
Ginekol Pol 2022;93(4):296-301.
Keywords
ultrasonography
prenatal
whirlpool sign
intestinal malrotation
midgut volvulus
Authors
Lin Yang
Huie Chen
Guorong Lv
Feifei Li
Jianmei Liao
Linfang Ke
References (15)- Lin JN, Lou CC, Wang KL. Intestinal malrotation and midgut volvulus: a 15-year review. J Formos Med Assoc. 1995; 94(4): 178–181.
- Liu S, Wu Q. Ultrasonographic diagnosis of intestinal malrotation with midgut volvulus in fetus. Chinese Journal of Medical Ultrasound (Electronic Edition). 2016; 13(11): 840–844.
- Yilmaz Y, Demirel G, Ulu HO, et al. Urgent surgical management of a prenatally diagnosed midgut volvulus with malrotation. Eur Rev Med Pharmacol Sci. 2012; 16 Suppl 4: 52–54.
- Sciarrone A, Teruzzi E, Pertusio A, et al. Fetal midgut volvulus: report of eight cases. J Matern Fetal Neonatal Med. 2016; 29(8): 1322–1327.
- Jakhere SG, Saifi SA, Ranwaka AA. Fetal small bowel volvulus without malrotation: the whirlpool & coffee bean signs. J Neonatal Perinatal Med. 2014; 7(2): 143–146.
- Kargl S, Wagner O, Pumberger W. Volvulus without malposition — a single-center experience. J Surg Res. 2015; 193(1): 295–299.
- Kornacki J, Czarnecka M, Błaszczyński M, et al. Congenital midgut volvulus associated with fetal anemia. Fetal Diagn Ther. 2010; 28(2): 119–122.
- Has R, Gunay S. 'Whirlpool' sign in the prenatal diagnosis of intestinal volvulus. Ultrasound Obstet Gynecol. 2002; 20(3): 307–308.
- Pracros JP, Sann L, Genin G, et al. Ultrasound diagnosis of midgut volvulus: the "whirlpool" sign. Pediatr Radiol. 1992; 22(1): 18–20.
- Tang X, Tao R, Zhang X, et al. Assessment of fetal superior mesenteric artery and vein by three-dimensional power Doppler sonography. Zhejiang Da Xue Xue Bao Yi Xue Ban. 2019; 48(4): 453–458.
- Noreldeen SA, Hodgett SG, Venkat-Raman N. Midgut volvulus with hemorrhagic ascites: a rare cause of fetal anemia. Ultrasound Obstet Gynecol. 2008; 31(3): 352–354.
- Ooms N, Matthyssens LEM, Draaisma JM, et al. Laparoscopic treatment of intestinal malrotation in children. Eur J Pediatr Surg. 2016; 26(4): 376–381.
- Sulkowski JP, Cooper JN, Duggan EM, et al. Early versus delayed surgical correction of malrotation in children with critical congenital heart disease. J Pediatr Surg. 2015; 50(1): 86–91.
- Ezer SS, Oguzkurt P, Temiz A, et al. Intestinal malrotation needs immediate consideration and investigation. Pediatr Int. 2016; 58(11): 1200–1204.
- Vassaur J, Vassaur H, Buckley FP. Single-incision laparoscopic Ladd's procedure for intestinal malrotation. JSLS. 2014; 18(1): 132–135.
