Ant. Abd. Wall Defects & GIT Anomalies U/S

8/17/2019 Ant. Abd. Wall Defects & GIT Anomalies U/S

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ANTERIOR ABDOMINAL ANTERIOR ABDOMINAL

WALL DEFECTS & WALL DEFECTS &

GASTROINTERSTINALGASTROINTERSTINALCONGENITALCONGENITAL

ANOMALIES ANOMALIES Prof.Dr. Maged Ahmed Abd Alraouf, Prof.Dr. Maged Ahmed Abd Alraouf,

Cairo Univ. Cairo Univ.


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STOMACHSTOMACH Fetus begins to swallow at 16W so Fetus begins to swallow at 16W so

should be seen after 1W routinel!.should be seen after 1W routinel!.

Can be seen as earl! as 1"W.Can be seen as earl! as 1"W.

#i$e varies de%ending on &uid#i$e varies de%ending on &uid

re'entl! swallowed.re'entl! swallowed.

U(#U(# &uid )lled stoma'h bubble &uid )lled stoma'h bubble

is seen as an ane'hoi' 'res'ent*is seen as an ane'hoi' 'res'ent*sha%ed stru'ture in leftsha%ed stru'ture in left

hemiabdomen.hemiabdomen.


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LIVER LIVER #ite of hemato%oiesis b! W .#ite of hemato%oiesis b! W .

Contributes to si$e of theContributes to si$e of the

abdomen .abdomen .

U(#U(# large homogenouslarge homogenous

stru'ture beneath thestru'ture beneath thedia%hragm at the right side.dia%hragm at the right side.


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GALL BLADDER GALL BLADDER Forms at + W. Forms at + W.

Passive role in the fetus. Passive role in the fetus.

U(#U(# seen at about - Wseen at about - W

small oval ane'hoi' stru'ture to the right ofsmall oval ane'hoi' stru'ture to the right of%ortal(umbili'al vein.%ortal(umbili'al vein.


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SMALL BOWELSMALL BOWEL A%%ears 'entrall! in the abdomen A%%ears 'entrall! in the abdomen

..

#hould not e'eed 6 mm in#hould not e'eed 6 mm in

diameter.diameter.

More e'hogeni' than large bowel More e'hogeni' than large bowel

until late in the third trimester asuntil late in the third trimester as

with more swallowed li/uor it 'anwith more swallowed li/uor it 'an

a%%ear more sonolu'ent.a%%ear more sonolu'ent.


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LARGE BOWELLARGE BOWEL 0eservoir for me'onium from 0eservoir for me'onium from

small bowel so diametersmall bowel so diameter

in'reases through %regnan'!.in'reases through %regnan'!. U(#U(# long tubularlong tubular

%eri%heral h!%oe'hoi'%eri%heral h!%oe'hoi'

stru'ture.stru'ture. o %eristalsis. o %eristalsis.


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OMPHALOCELEOMPHALOCELE

Anterior abdominal wall Anterior abdominal wall

defe't where abdominaldefe't where abdominal

'ontents herniates into base of'ontents herniates into base of

umbili'al 'ord .umbili'al 'ord .

2igh maternal serum A F P. 2igh maternal serum A F P.

ot diagnosed until after 13 W ot diagnosed until after 13 W

A##4C. A##4C. 5 1" 1 15 1" 1 1

5U00 789F850.5U00 789F850.


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OMPHALOCELEOMPHALOCELE

U/SU/S Ant. midline mass with Ant. midline mass with'overing membrane'overing membrane

2erniation of abdominal 2erniation of abdominalvis'era atvis'era at basebase of the 'ordof the 'ord

:liver ,bowel ,;(stoma'h < .:liver ,bowel ,;(stoma'h < .

Umb.Umb. 'ord'ord entersenters the mass .the mass . Fetal as'ites . Fetal as'ites .


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GASTROSCHISISGASTROSCHISIS

Ant . Abd . W. Defect !e"e fet#$ Ant . Abd . W. Defect !e"e fet#$

%'ce"# (")t"*de t!")*+! # %'ce"# (")t"*de t!")*+! #

(#"#*,b$c#$ defect t) t!e(#"#*,b$c#$ defect t) t!e 05 05 )f # n)",#$$- c$)'ed *,b."n+.)f # n)",#$$- c$)'ed *,b."n+.

N)t d#+n)'ed *nt$ #fte" W.N)t d#+n)'ed *nt$ #fte" W.

H+! ,#te"n#$ A .F .P .H+! ,#te"n#$ A .F .P .

U'*#$$-U'*#$$- 4 4 #'')c#ted#'')c#ted

#n),#$e' ') (")+n)'' +))d.#n),#$e' ') (")+n)'' +))d.


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U/SU/S M*$t($e b)e$ $))(' 0',#$$ & $#"+e 1M*$t($e b)e$ $))(' 0',#$$ & $#"+e 12)#tn+ f"ee$- n #,n)tc 2*d t! n)2)#tn+ f"ee$- n #,n)tc 2*d t! n)

c)%e"n+ ,e,b"#ne .c)%e"n+ ,e,b"#ne .

00 0A==D 0A==D 1 ed+e .1 ed+e . Occ#')n#$- 't),#c! & "#"e$- $%e" ,#-Occ#')n#$- 't),#c! & "#"e$- $%e" ,#-

!e"n#te!e"n#te

N)",#$ n'e"t)n )f *,b.c)"d t) t!eN)",#$ n'e"t)n )f *,b.c)"d t) t!e

8F5 8F5 )f t!e ,#''.)f t!e ,#''. St),#c! & U.B. C$)'e t)et!e".St),#c! & U.B. C$)'e t)et!e".

P)$-!-d"#,n)' .P)$-!-d"#,n)' .


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SONOGRAPHICSONOGRAPHIC

COMPARISONCOMPARISON

GASTROSCHISGASTROSCHISISISN) ,e,b"#neN) ,e,b"#ne

c)%e"n+ ,#''c)%e"n+ ,#''

C)"d n'e"t' nC)"d n'e"t' n#bd.#$$.#bd.#$$.

B)e$ !e"n#te'B)e$ !e"n#te'b*t 't),#c! c#nb*t 't),#c! c#n

#$').#$').

OMPHALOCELOMPHALOCELEEMe,b"#neMe,b"#ne

c)%e"n+ ,#''.c)%e"n+ ,#''.

Int) ,e,b"#ne.Int) ,e,b"#ne.

L%e" *'*#$$-L%e" *'*#$$-!e"n#te' b*t!e"n#te' b*t't),#c! c#n #''t),#c! c#n #'

e$$. e$$.


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BOD3 STAL4BOD3 STAL4

ANOMAL3 ANOMAL3 MA5OR ABD. WALLMA5OR ABD. WALL

DEFECT .DEFECT .

SEVERE 43PHOSCOLIOSIS.SEVERE 43PHOSCOLIOSIS.RUDIMENTAR3 UMB. CORD.RUDIMENTAR3 UMB. CORD.

LETHAL ANOMALY. LETHAL ANOMALY.


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BOD3 STAL4 ANOMAL3BOD3 STAL4 ANOMAL3

U/SU/SMA5OR ABD. WALL DEFECT .MA5OR ABD. WALL DEFECT .

SEVERE 43PHOSCOLIOSIS.SEVERE 43PHOSCOLIOSIS.

SHORT OR ABSENT UMB. CORD.SHORT OR ABSENT UMB. CORD. THE LIVER T3PICALL3 ISTHE LIVER T3PICALL3 IS

DIRECTL3 ATTACHED TO THEDIRECTL3 ATTACHED TO THE

PLACENTA.PLACENTA.


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BLADDER E6STROPH3 BLADDER E6STROPH3

Defect )f t!e c#*d#$ f)$d )f t!e Ant.Abd.W.7Defect )f t!e c#*d#$ f)$d )f t!e Ant.Abd.W.7

',#$$ defect c#*'e' e('(#d#' #$)ne 8',#$$ defect c#*'e' e('(#d#' #$)ne 8

$#"+e defect $e#d' t) e9()'*"e )f t!e$#"+e defect $e#d' t) e9()'*"e )f t!e

()'t. b$#dde" #$$.()'t. b$#dde" #$$.

U/SU/S :'*'(ected !en n ("e'ence )f n)",#$:'*'(ected !en n ("e'ence )f n)",#$

#,n)tc 2*d 8t!e U.B. I' n)t 'een0d*"n+#,n)tc 2*d 8t!e U.B. I' n)t 'een0d*"n+

;, 1 An e!)+enc ,#'' ' 'een (")t"*dn+;, 1 An e!)+enc ,#'' ' 'een (")t"*dn+

f"), t!e $)e" Abd.W. C$)'e t) U,b.f"), t!e $)e" Abd.W. C$)'e t) U,b.

#"te"e'.#"te"e'.


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CLOACAL E6STROPH3 CLOACAL E6STROPH3

B)t! U.T.& G.I.T. #"e n%)$%ed.B)t! U.T.& G.I.T. #"e n%)$%ed.

O,(!#$)ce$eO,(!#$)ce$e

E9't")(!- )f b$#dde"E9't")(!- )f b$#dde"

I,(e"f)"#te #n*'I,(e"f)"#te #n*'

S(n#$ defect #' ,enn+),-e$)ce$eS(n#$ defect #' ,enn+),-e$)ce$e

U(#U(#

$#"+e nf"# *,b$c#$ defect$#"+e nf"# *,b$c#$ defecte9tend' t) (e$%' < !e"n#tede9tend' t) (e$%' < !e"n#ted

b)e$


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G.I.T. ANOMALIESG.I.T. ANOMALIES

>A8UA5 #54MAC2 ? >A8UA5 #54MAC2 ?

ABSENT ABSENT

@AM. C2#5 @AM. C2#5 DIAPH . HERNIA DIAPH . HERNIA 0C2C7 0C2C7 PH3S . EMPT3INGPH3S . EMPT3ING

A#5 A#5 ESOPHAGEAL ATRESIA ESOPHAGEAL ATRESIA


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ABSENT STOMACH ABSENT STOMACH

BUBBLEBUBBLE


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SO GESOPHAGEAL


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ESOPHAGEALESOPHAGEAL

ATERSIA ATERSIA Ma! be asso'iated with tra'heo* Ma! be asso'iated with tra'heo*eso%hageal )stula .eso%hageal )stula .

Asso'. Asso'. >AC508 5 1" 1 1>AC508 5 1" 1 1 . .

U(#U(# absen'e of &uid*)lled stoma'habsen'e of &uid*)lled stoma'hbubble. #mall A.C.bubble. #mall A.C.

%ol!h!dramnios.%ol!h!dramnios.With )stulaBstoma'hWith )stulaBstoma'h

bubble seen.bubble seen.


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ESOPHEGEAL ATRESIA ESOPHEGEAL ATRESIA


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DUODENALDUODENAL


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DUODENALDUODENAL

ATRESIA ATRESIA Asso'iated with 5 1 ; Cong. Asso'iated with 5 1 ; Cong. 2t. Dis. 2t. Dis.

U(#U(#

D4U8 U8 #9= D4U8 U8 #9= :distended:distendedstoma'h ; %roimal duodenum


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5E5UNAL5E5UNAL


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5E5UNAL 5E5UNAL

ATRESIA ATRESIA Tripple or quadrubleTripple or quadrublebubble signbubble sign

(a cross section(a cross section

cut through severalcut through several

dilated loops of boel !.dilated loops of boel !.


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ASCITES ASCITES P'*d)A'cte'P'*d)A'cte' : #bd),n#$ ,*'c$e': #bd),n#$ ,*'c$e'

c#n #((e#" #' # t!n !-()e!)c ",c#n #((e#" #' # t!n !-()e!)c ",

#$)n+ t!e #nt. Abd..#$)n+ t!e #nt. Abd..

T"*e #'cte' ' #$#-' #bn)",#$ .T"*e #'cte' ' #$#-' #bn)",#$ . A'')c#ted t! A'')c#ted t! h!dro%s fetalis ,h!dro%s fetalis ,

%leural eusion, bowel%leural eusion, bowel

%erforation,urinar! tra't%erforation,urinar! tra'tru%ture,gl!'ogen storage diseaseru%ture,gl!'ogen storage disease..


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ABDOMINAL C3STS ABDOMINAL C3STS

C248D4CA8C248D4CA8 0d$.c),,)n b$e0d$.c),,)n b$e

d*ct 1d*ct 1

2PA59C 2PA59C 4>A09A 4>A09A

M#509C 40 4M5A8 M#509C 40 4M5A8

95#59A8 DUP89CA594 95#59A8 DUP89CA594


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Ant. Abd. Wall Defects & GIT Anomalies U/S