Fetal Abdomen and Abdominal Wall

Question 1

Hypoechoic curved line separating lungs from liver and stomach on superior aspect

Answer 1

Diaphragm

Question 2

Left lobe is larger than the right with fluid filled gB inferior to liver margin

Answer 2

Liver

Question 3

Seen in upper left abdomen posterior to stomach

Answer 3

Spleen

Question 4

After midgut rotation contains return to abdominal cavity by 11/12th week and no later than 14 weeks

Answer 4

abdominal wall

Question 5

Can contain bowel stomach and bladder

Answer 5

Midgut

Question 6

o Protrusion of intestines/loops of bowel through open defect in anterior abdominal wall
o NO SAC usually on the RIGHT sided adjacent to umbilical cord
o NOT associated with other chromosomal abnormalities
o Associated with ↑ MSAFP

Answer 6

Gastroschisis

Question 7

o Failure of intestines and other abdominal contents to return into abdomen after midgut rotation
o Mass is contiguous with umbilical cord, CENTRALLY located
o SAC covering herniated organs (INCLUDING LIVER)
o HIGH association with other congenital anomalies
o M/C Trisomy 13, 18 or cardiac defects *** on TEST

Answer 7

Omphalocele

Question 8

o Midline defect of lower abdominal wall with protrusion of urinary bladder.
o Can be associated with other genital anomalies

Answer 8

Bladder Exstrophy

Question 9

o Abnormal development of diaphragm usually occur on left side
o Stomach, Spleen, colon, liver or bowel could herniate into chest
o Associated with pulmonary hypoplasia and polyhydramnios
o Heart is displaced towards the right

Answer 9

Congenital Diaphgramtic Hernia

Question 10

o Umbilical Vein courses to the left side of the fetal abdomen

Answer 10

Persistent right Umbilical vein

Question 11

difficult to image unless fetus is swallowing or there is stenosis

Answer 11

Esophagus

Question 12

• left side on transverse view seen in upper left abdomen. If muscular layer is thickened= hypertrophic pyloric stenosis

Answer 12

Stomach

Question 13

mixed echogenicity to cystic in appearance. Peristalsis seen in late second trimester

Answer 13

Intestines

Question 14

mixture of bile swallowed vernix, fetal skin and hair

Answer 14

Meconium

Question 15

discontinuation of esophagus accompanied by a distal tracheo esophageal fistula; can get anywhere in GI tract
o Associated with cardiac, GI, genitourinary and musculoskeletal anomalies
o S/S: small to absent fluid filled stomach and POLY

Answer 15

Esophageal atresia

Question 16

failure of recanalization of the duodenum
o “Double bubble sign”- simultaneous distention of stomach and first portion of duodenum & POLY
o Assoc with cardiac and vertebral anomalies & Downs syndrome

Answer 16

Duodenal atresia

Question 17

obstruction of intestine w/ small bowel diameter >7mm

o Increased peristalsis on fluid filled loops and POLY

Answer 17

Intestinal atresia

Question 18

occurs after bowel perforation.
o Associated with cystic fibrosis
o Sono: bright echogenic intra-abdominal foci with shadow, Fetal ascites, POLY

Answer 18

Meconium Peritonitis

Question 19

congenital germ cell tumor arising from sacral area
o Pre-sacral- arises anterior aspect of sacrum and grows internally into the fetal pelvis
o Sacrococcygeal- arises from the posterior sacrum/ coccyx and projects externally/ exophytically from the fetal sacrum
o Sono: a large complex mass, cystic solid and calcified components and hypervascular

Answer 19

Teratomas