Fetal Abdomen

Question 1

Sono appearance of the;

Stomach, Liver, Spleen, GB

Answer 1

Stomach: anechoic on the left side
Liver: hypoechoic, right side, (lt lobe is larger in fetal body)
Spleen: homogenous, LUQ
GB: anechoic, Rt sided and Inf to Umb. Vein

Question 2

Reasons you may not see the stomach?

Answer 2

Could be empty
Obstruction 
Hernia
Oligohydramnios 
Microgastria

Question 3

What could echogenic material be in the stomach?

Answer 3

Could be the Vernix, Protein or intra-amniotic hemorrhage

Question 4

Esophageal Atresia occurs every?

And is associated with…

Answer 4

1:2500

Associated with TE Fistula

Question 5

Anorectal Atresia and VACTERL are anomalies associated with?

Answer 5

Esophageal Atresia

Question 6

Duodenal Atresia

Answer 6

Blockage of lumen leading from the stomach to the duodenum, causing stomach to remain full of amniotic fluid.

• AF backs up into stomach
• 30% have T21

Question 7

____% of infants with _______ have _______

Answer 7

30% of infants with duodenal atresia have T21

Question 8

The more ______ the obstruction of duodenal atresia, the ______ severe

Answer 8

More DISTAL the obstruction, the LESS severe

Question 9

Gallbladder is typically seen around

Answer 9

20 weeks

Question 10

Biliary Atresia

Answer 10

Damaged or absent gallbladder

-Once born can lead to jaundice, dark urine and hepatomegaly

Question 11

Reasons to see gall stones and sludge in fetus?

Answer 11

Possible placental abruption, estrogen (hormonal) or if there is Maternal Sickle Cell Anemia

Question 12

Choledochal Cyst

Answer 12

Congenital cystic dilation that communicates with the bile duct but is separate from the gallbladder.
-most common cystic dilation of CBD

Question 13

Most common cystic dilation of the CBD

Answer 13

Choledochal Cysts

Question 14

Choledochal Cysts are associated with

Answer 14

Cholangiocarcinoma tumor, stones and inflammation of the gallbladder

Question 15

Liver Calcs could be due to

Answer 15

Hepatic tumors
Intrauterine Infections
Vascular Insult

Question 16

Enlarged liver could be due to

Answer 16

Severe hemolytic disease
Congenital infection
Beck with- weidemann syndrome

Question 17

Uncommon tumors of the liver

Answer 17

Hamartoma (benign)
Hemangioendothelioma (mal)
Hemangioma (benign)
Metastasis from a neuroblastoma

Question 18

Hepatoblastoma

Answer 18

Most common cancer in kids under 5 years
Echogenic mass with vascularity
Elevated AFP

Question 19

Spleen, basic info

Answer 19

Very homogeneous

Cysts are rare

Question 20

Splenomegaly can occur with

Answer 20

RH immune disease
Beckwith-weidemann Syndrome
Infection

Question 21

Gastric muscles start moving

Answer 21

4-5 months

Weeks 16-24

Question 22

What weeks are meconium starting to be produced

Answer 22

15th-16th week

Question 23

After ____ weeks, peristalsis increases

Answer 23

27 weeks

Question 24

Variable appearance of SB

Answer 24

Early gestations begins hyperechoic and less noticeable, later term pregnancy becomes more hypoechoic and noticeably tubular in the body

Question 25

Meconium Peritonitis

Answer 25

Rupture of colon/bowel before birth Stool is in the fetus’s surrounding peritoneum causing infection May occur after an obstruction or atresia, volvulus or ileus

Question 26

Sono of meconium peritonitis

Answer 26

Echogenic with intra-abdominal foci (causing shadowing) | Possible to see Ascites and polyhydramnios

Question 27

Causes for SBO

Answer 27

Malrotation of bowel Atresia(s) Volvulus Cystic Fibrosis

Question 28

Atresia of SB

Answer 28

Obstruction with subsequent distention of belly Multiple fluid filled bowel loops (can occur anywhere of GI tract) Possible to see polyhydramnios

Question 29

Echogenic Bowel, | Good or Bad? Why?

Answer 29

Not great! Indication of lack of hydration or altered meconium Increased risk for T21 and Cystic Fibrosis

Question 30

Having an echogenic bowel can put the baby at risk for?

Answer 30

Trisomy 21 | Cystic Fibrosis

Question 31

Possible causes for echogenic bowel

Answer 31

Intra-amniotic blood (from abruption) Severe IUGR (intrauterine growth restriction) Unexplained Uterine Demise

Question 32

Anal Rectal Atresia

Answer 32

Disorder ranging from separation or absence of anus Possibly due to imperforate anus Causes distal colon to be dilated and calcified meconium

Question 33

What is associated with Anal-rectal Atresia

Answer 33

Imperforate Anus | VACTERL

Question 34

Imperforate Anus

Answer 34

Membrane covers where the anus should be, not allowing the passing of stool

Question 35

VACTERL

Answer 35

``` Vertebral anomalies Anal atresia Cranial Defects Tracheo-Esophageal atresia Renal anomalies Limb abnormalities ```

Question 36

Surgery for choledochal cysts after birth may help prevent

Answer 36

Cholangitis Biliary Obstruction Cirrhosis GB Calcs