Case Reports
Segmental dilatation of the jejunum resembling prenatal volvulus

https://doi.org/10.1053/jpsu.2001.23978Get rights and content

Abstract

A case of prenatally diagnosed intestinal obstruction caused by segmental dilatation of the jejunum is presented. Routine ultrasound scan showed mild polyhydramnios, a dilated small bowel loop, and scoliosis. On repeat ultrasound scan a volvulus was suspected, which led to cesarean section and laparotomy of the newborn, revealing the underlying pathology. Segmental resection and end-to-end anastomosis were followed by an uneventful recovery. Segmental dilatation of the intestine should be considered as a cause of prenatally manifested intestinal obstruction. Concomitant anomalies are frequent and may be helpful in making the correct diagnosis. J Pediatr Surg 36:927-929. Copyright © 2001 by W.B. Saunders Company.

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Case report

Routine ultrasound scan in a 24-year-old woman (gravida 1) at 30 weeks' gestation showed mild polyhydramnios, a dilated small bowel loop, and scoliosis. Amniocentesis showed a normal karyotype.

Repeat ultrasonography at 37 and 38 weeks' gestation showed increasing polyhydramnios as well as a marked increase in diameter of the dilated bowel loop (Figs 1 and 2).

. Prenatal ultrasound at 38 weeks' gestation shows the marked dilatation of a bowel loop.

. Prenatal ultrasound at 38 weeks' gestation;

Discussion

Since the first description of segmental diltation of the colon by Swenson and Rathauser in 19593 several reports affecting the small and large bowel have been published. Common features include a single, dilated bowel segment without evidence of intrinsic or extrinsic obstruction or abnormal innervation. Gross appearance frequently includes enlarged and tortuous vessels, thick bowel wall, or, sometimes, a paper-thin walled intestinal segment.4, 5

The etiology of this entity is unclear. Irving

References (8)

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  • Segmental dilatation of colon detected on prenatal ultrasound

    2019, Journal of Pediatric Surgery Case Reports
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    Other clinical presentations, including abdominal pain, gastrointestinal bleeding, and anemia, are nonspecific. Associated anomalies are found in more than 50% of patients with SDI, and include anorectal anomaly, malrotation, and omphalomesenteric duct [6,7,8,9]. SDI is difficult to diagnose not only prenatally but also antenatally, especially preoperatively.

  • Antenatal ultrasonographic features associated with segmental small bowel dilatation: An unusual neonatal condition mimicking congenital small bowel obstruction

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    In some cases, association of Meckel diverticulum with SDI has been reported.2 SDI associated with prenatal ultrasonographic (US) findings, mimicking prenatal volvulus, cystic mass or bowel stenosis, has rarely been described.3–8 However, the diagnosis of SDI was confirmed at surgery in all cases.

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  • Congenital Segmental Dilatation of the Intestine

    2020, Pediatric Surgery: General Principles and Newborn Surgery: Volume 1
  • Congenital segmental dilatation of jejunum: A rare entity

    2019, Journal of Indian Association of Pediatric Surgeons
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Address reprint requests to Stuart Hosie, MD, Department of Pediatric Surgery, University Hospital, Theodor-Kutzer-Ufer, D-68167 Mannheim, Germany.

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