OB- abdo/GI Flashcards
Small or absent fetal stomach is associated with?
- can be normal (allow 30 mins to fill)
associated with:
- aneuplody
- tracheoesophageal fistula
- oilohydranios
what is esophageal atresia?
- congenital absence of a segment of the espogus
associated with:
- tracheoesophageal fistula (TEF)
What is the most common esophageal fistula?
fistula connecting the distal portion of the esophagus with the trachea (90%)
what should an esophageal atresia be suspected?
when an empty or small fetal stomach is seen in the presence of polyhydramnios
what is the upper neck pouch sign?
- visualization of the proximally dialated esophagus
grouping of anomalies with esophageal atresia is known as?
VACTERL
Abnormal gastric dilation is most commonly seen in association with?
duodenal atresia
what is the most common site of intestinal atresia?
- what sign is seen?
duodenal atresia
- double bubble sign
what is double bubble sign?
- 2 fluid filled bubbles seen with duodenal atresia
- dialated stomach and dialated proximal duodenum
what is duodenal atresia associated with?
- coexisting anomalies (50%)
- 1/3rd have tri-21
what is the most common etiology associated with jejunoileal atresia?
isolated vascular compromise
jejunal-ileal obstruction is diagnosed based on?
dialated loops of bowel
- without dialated stomach
- somtimes with hyper-peristalsis
The top normal lumen diameter used to diagnose bowel dilation is?
7mm
what is the apple peel sign?
- seen with jejunal atresia
cystic fribrosis is a common underlying etiology for what?
- ileal obstruction with or without meconium
polyhydramnios is less common in what kind of atresia?
- lower bowel obstructions than in duodenal atresia
what is the most common large bowl atresia?
anorectal atresia
what has the highest incidence of associated anomalies of any of the GI atresias?
anorectal malformations (48-98%)
sonographic diagnosis of anorectal atresia?
0 dialated loops of small bowel or colon in the absence of polyhydramnios
management of anorectal atresia?
- fetal echocardigram
- genetic counseling
what is echogenic bowel characterized by?
echos of bowel are as echogenic as the iliac crest
echogenic bowel: common associated risks? (8)
Aneuploidy Cystic fibrosis Swallowed fetal blood Infection Gastrointestinal atresias Meconium peritonitis Intrauterine growth restriction Fetal Demise
what is the most common anomaly of the abdominal wall?
omphalocele
what is omphalocele?
- defect in the anterior abdominal wall and the site of the imbilical cord insertion
how is omphalocele identified?
- herniation of abdominal organs (liver and bowel) into the base of the umbilical cord
what is associated with omphalocele?
- pentaolgy of cantrell
- beckwidth-wiedemann syndrome
- may be isolated
- heart defects
- chromosome anomalies (tri-18 m/c)
how are fetal anterior wall abnormalities diagnosed on u/s?
- Ventral mass seen at the cord insertion site
- Omphalocele may be small (only bowel) or large (bowel and liver) and appear solid
- covered by a membrane, which represents the amnion covering of umbilical cord
- Ascites may be seen in peritoneal membrane
what is pentalogy of cantrell associated with? (5)
- ectopia cordia
- heart defect
- diaphragmatic hernia
- pericardial defect
- omphalocele
what is bechwidth- wiedemann syndrome characterized by? (4)
- macrosomia
- macroglossia
- omphalocele
- renal neoplasm
what is gastroschisis?
- where is it located?
- cleft defect of the anterior abdominal wall with extrusion of abdominal organs into the amniotic cavity
- usually only contains small bowel and is isolated
- most commonly to the right of midline at umbilical level
what is the main difference between gastrochisis and omphalocele?
in gastroschisis the herniated content is not covered by a membrane and the herniated content is free in the amniotic fluid
risk of gastrochisis?
- teenage mothers
- tobacco use
- drug use
- pseudoephedrine
what is gastroschisis associated with? (3)
- atresias
- stenosis
- perforations
what 6 things does the fetal abdomen contain?
- umbilical vein
- liver
- IVC
- descending aorta
- spleen
- fetal stomach
what 6 things does the fetal abdomen contain?
- umbilical vein
- liver
- IVC
- descending aorta
- spleen
- fetal stomach
when can hepatomegly been seen?
- in severe hemolytic diseases
- splenomegaly
- hydrops
splenomegly is associated with?
severe hemolytic disease due to isoimmunization and infection
asplenia is associated with?
- situs incersus
what is associated with heterotaxy syndromes?
- asplenia
- polysplenia
GB may be seen sonographically after what week?
20 weeks GA
what is a neuroblastoma?
- a malignant tumor of the adrenal gland
- most common neonatal tumor
- complex mass and areas of calcifications
what is a hemorrhage?
- associated with fetal destress in older fetuses
- simular to adrenal or renal tumor
causes of ascites? (7)
Genitourinary Gastrointestinal Liver Cardiac Infections Metabolic storage disorders Idiopathic
causes of pseudoascites?
- gastrointestinal obstruction with bowel perforation
- may present as meconium peritonitis and ascites
Nongastrointestinal causes include: Immune and nonimmune hydrops Urinary tract obstruction Congenital infection Some abdominal tumors
psedoasciates on u/s?
Sonolucent band near fetal anterior abdominal wall commonly identified during routine obstetric examinations in fetus over 18 weeks of gestation
- band results from normal musculature surrounding abdominal wall
- always confined to anterior fetal abdomen and centrally located
- never outlines falciform ligament
