Sonographic characteristics of fetal intestinal volvulus: report of four cases / 中华围产医学杂志

ABSTRACT

Objective:To investigate the characteristic of ultrasound in diagnosing fetal intestinal volvulus.Methods:From April 2015 to May 2018, four cases of fetal intestinal volvulus indicated by prenatal ultrasound in the Affiliated Hospital of Jining Medical College and confirmed either by autopsy or by postnatal surgery, were retrospectively analyzed. A total of 11 ultrasound scans had been performed on the four cases, and the dynamic and static ultrasound features were summarized. Pregnancy outcomes and concomitant malformations were also followed up. Descriptive statistical analysis was used.Results:The direct ultrasonographic patterns of intestinal volvulus in the four cases were "whirlpool" signs (six times), clockwise wrapping of branch vessels of the superior mesenteric vein and the superior mesenteric artery (five times), and "coffee bean" sign (three times); the indirect signs included dilated small intestine (11 times), ascites (eight times), polyhydramnios (five times), peritoneal calcification(four times), pseudocysts(once). Out of the 11 ultrasound examinations, early-stage volvulus was detected on three occasions, all with "whirlpool" signs and clockwise wrapping of branch vessels of the superior mesenteric vein and the superior mesenteric artery. As the disease progressed to the meconium peritonitis stage, indirect signs emerged while the initial two signs can diminished. Postnatal surgery or autopsy after labor induction confirmed the segmental volvulus in the four cases, of which three were complicated by intestinal atresia. No intestinal malrotation was found.Conclusion:Typical direct signs and atypical indirect signs could be identified in the sonogram findings of fetal volvulus, and are important for diagnosing fetal volvulus.