Document Detail

Congenital duodenal obstruction: early antenatal ultrasound diagnosis.
MedLine Citation:
PMID:  10955559     Owner:  NLM     Status:  MEDLINE    
Twenty-nine patients with congenital duodenal obstruction (DO) detected as a "double bubble" (DB) on antenatal ultrasound (US) or diagnosed postnatally were seen at the Women's and Children's Hospital between 1985 and 1994; 24 (83%) had antenatal scans, with 21 (87%) DBs visualised. The 3 fetuses with normal scans who developed DO postnatally had duodenal "windsocks". Five of the 24 scanned patients (21%) were found to have a DB before 20 weeks' gestation: 1 simple duodenal atresia, 2 duodenal atresias with chromosomal abnormalities (1 trisomy 21 and 1 triploidy), 1 biliary atresia with a pre-pyloric vein, and 1 malrotation. Sixteen (67%) cases were detected with scans after 20 weeks (range 28-36 weeks); 12 (75%) of these were done for polyhydramnios. In response to a questionnaire to 9 of the 16 parents whose fetuses underwent a late scan, 5 had had normal early scans elsewhere and 4 did not respond (4 of the remaining 7 had died and 3 were lost to follow-up). Eleven of the 29 patients (38%) had abnormal karyotypes, and 4 (22%) of the 18 with a normal karyotype had associated anomalies. Two sets of familial cases were noted. Early antenatal diagnosis of DO is possible in a minority of cases, and this early diagnosis may be associated with an increased risk of other pathology. Furthermore, early demonstration of a DB at routine US prior to 20 weeks allows appropriate counseling and the option of mid-trimester termination, whereas this is more difficult later in the pregnancy. In all cases detected antenatally, planning of delivery and parent counseling should be achieved.
M J Lawrence; W D Ford; M E Furness; T Hayward; T Wilson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric surgery international     Volume:  16     ISSN:  0179-0358     ISO Abbreviation:  Pediatr. Surg. Int.     Publication Date:  2000  
Date Detail:
Created Date:  2000-11-29     Completed Date:  2000-12-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8609169     Medline TA:  Pediatr Surg Int     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  342-5     Citation Subset:  IM    
Department of Paediatric Surgery, Women's and Children's Hospital, North Adelaide, South Australia.
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MeSH Terms
Abnormalities, Multiple / genetics,  ultrasonography*
Duodenal Obstruction / complications,  congenital*,  genetics,  ultrasonography*
Genetic Counseling
Infant, Newborn
Pregnancy Trimester, Second
Retrospective Studies
Ultrasonography, Prenatal / methods*

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