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Case Reports
.2024 Apr 8:25:e942838.
doi: 10.12659/AJCR.942838.

Importance of Prenatal Diagnosis of Ileal Atresia in Gestational Diabetes Cases

Affiliations
Case Reports

Importance of Prenatal Diagnosis of Ileal Atresia in Gestational Diabetes Cases

Sorina Cristina Chelu et al. Am J Case Rep..

Abstract

BACKGROUND Maldevelopment of the fetal bowel can result in the rare condition of intestinal atresia, which results in congenital bowel obstruction. This report describes a case of prenatal diagnosis of fetal ileal atresia at 22 weeks' gestation. CASE REPORT Here, we present a 24-year old woman who was 22 weeks into her first pregnancy when she underwent routine fetal ultrasound. She was diagnosed with gestational diabetes mellitus. Her body mass index was normal and she had normal weight gain. The ultrasonographic examination performed revealed a hyperechoic bowel and a small dilatation of the bowel. The couple was counselled for possible intestinal atresia and its postnatal implications. At 33 weeks of gestation, polyhydramnios appeared, and the intestinal distension was much more pronounced, with hyperechoic debris in the intestinal lumen (succus-entericus). After birth, surgery was performed and we concluded the patient had type II atresia, which was surgically treated. CONCLUSIONS This report has highlighted the importance of antenatal ultrasound in detecting fetal abnormalities, and has shown that rare conditions such as intestinal atresia can be accurately diagnosed and successfully managed. Surgical correction, if implemented promptly after stabilizing the general condition, can have a relatively good prognosis. Coexisting fetal ileal atresia and gestational diabetes mellitus are rare occurrences, which can make each condition even more difficult to treat.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1.
Figure 1.
(A, B) Transabdominal ultrasound of the fetus at 22 weeks, showing a hyperechoic bowel and dilated loop. 1, Placenta; 2, dilated intestinal loops; 3, vertebral column; 4, heart; 5, amniotic fluid.
Figure 2.
Figure 2.
(A) Transabdominal ultrasound of the fetus, aged 23-weeks and 3-days, showing a hyperechoic bowel. (B) Dilated loop. 1, section through the abdomen; 2, dilated intestinal loops; 3, amniotic fluid; 4, placenta.
Figure 3.
Figure 3.
Transabdominal ultrasound of the fetus, aged 24 weeks and 4 days, showing a dilated loop with diameter >7 mm. Hyperechoic dilated intestinal loops are visible. 1, placenta; 2, amniotic fluid; 3, umbilical cord with 2 arteries and a vein; 4, dilated intestinal loops.
Figure 4.
Figure 4.
Transabdominal ultrasound of the fetus, aged 33 weeks, showing intestinal distension with hyperechoic debris in the intestinal lumen (succus-entericus) with continuous peristalsis, by real-time imaging examination. 1, section through the abdomen; 2, placenta; 3, dilated intestinal loop; 4, amniotic fluid.
Figure 5.
Figure 5.
(A, B) Resection of the entire section of the small bowel in the newborn, aged 5 days. 1, ileum; 2, mesenteries; 3, jejunum.
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