产前超声诊断胎儿先天性脐肠瘘并发肠脱垂2例分析

Analysis of 2 cases of fetal congenital omphalo-enteric fistula with intestinal prolapse diagnosed by prenatal ultrasonography

目的探讨胎儿先天性脐肠瘘并发肠脱垂产前超声表现,提高对该病的认识和产前超声诊断水平。方法回顾性分析2016年7月至2017年9月福建医科大学附属第一医院2例出生后经手术证实为先天性脐肠瘘并发肠脱垂的产前超声图像,将产前超声表现与出生后大体图像及术中情况进行对比分析,结合相关文献总结其特征性产前超声表现。结果 2例产前超声均误诊为脐膨出,经产后及小儿外科手术证实为先天性脐肠瘘并发肠脱垂,该病产前超声具有蒂窄、肠管特殊、被膜不完整等特征。结论胎儿先天性脐肠瘘并发肠脱垂虽罕见,但产前超声具有特征性表现,应提高对该病认识,减少误诊,从而为产前咨询及临床选择分娩时机提供帮助。

Objective To investigate the prenatal ultrasonographic manifestations of fetal congenital omphalo-enteric fistula with intestinal prolapse and improve the understanding and diagnosis of this disease.Methods A retrospective analysis of the prenatal ultrasonographic features was performed in 2 cases of fetal congenital omphalo-enteric fistula with intestinal prolapse comnfirmed after surgery between July 2016 and September 2017 in First Affiliated Hospital of Fujian Medical University,and the ultrasonographic manifestations were compared with postnatal looks and intraoperative conditions.Characteristics of prenatal ultrasonographic manifestations were summarized.Results Both cases were misdiagnosed as omphalocele by prenatal ultrasonography.Congenital omphalo-enteric fistula with intestinal prolapse was verified by surgery after delivery.A narrow pedicle,special bowel-shape and incomplete capsule were its prenatal ultrasonic characteristics.Conclusion Fetal congenital omphalo-enteric fistula with intestinal prolapse is rare,but has particular prenatal ultrasonographic manifestations.Strengthening the understanding of the disease,reducing misdiagnosis and improving prenatal ultrasound diagnosis will provide help for prenatal counseling and clinical choice for time of delivery.