Journal of Medical Ultrasonics

, Volume 41, Issue 3, pp 397–400 | Cite as

Fetal stomach paracentesis in combined duodenal and esophageal atresia

  • Ikuko Kadohira
  • Kei Miyakoshi
  • Naoki Shimojima
  • Tadashi Matsumoto
  • Kazuhiro Minegishi
  • Mamoru Tanaka
  • Tatsuo Kuroda
  • Yasunori Yoshimura
Case Report

Abstract

Fetuses with concomitant duodenal atresia (DA) and esophageal atresia (EA) might develop in utero gastric rupture as well as neonatal respiratory complication due to dilated stomach and duodenum. Our patient with the typical “double bubble” appearance was highly suspected to have DA in the second trimester. Follow-up examinations revealed a massively dilated stomach and duodenum with a dilated distal esophagus, indicating concomitant DA and EA. With advancing pregnancy, the fetal abdomen progressively increased in size by retention of fluid in the closed loop of DA and EA. To avoid gastric perforation, prenatal stomach paracentesis using an ultrasound-guided needle was performed three times until delivery. A male neonate born at 37 weeks gestation showed no respiratory complication. Perinatal clinical features and operative findings revealed combined DA and EA (gross type A). He was successfully managed with duodenoduodenostomy, followed by esophago-esophagostomy. On fetal sonography, the marked “double bubble” appearance and the cystic structure presenting peristalsis-like movement above the diaphragm were indicative of concomitant DA and EA. Fetal stomach paracentesis could contribute to the improvement of perinatal outcomes in fetuses with this pathological condition.

Keywords

Duodenal atresia Esophageal atresia Paracentesis Gastric juice Sonography Magnetic resonance image 

Notes

Conflict of interest

The authors declare no conflict of interest related to the submission of this manuscript.

Ethical standards

The study was performed in accordance with the Declaration of Helsinki, and informed consent was obtained from the woman where appropriate.

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Copyright information

© The Japan Society of Ultrasonics in Medicine 2014

Authors and Affiliations

  • Ikuko Kadohira
    • 1
  • Kei Miyakoshi
    • 1
  • Naoki Shimojima
    • 2
  • Tadashi Matsumoto
    • 1
  • Kazuhiro Minegishi
    • 1
  • Mamoru Tanaka
    • 3
  • Tatsuo Kuroda
    • 2
  • Yasunori Yoshimura
    • 1
  1. 1.Department of Obstetrics and Gynecology, School of MedicineKeio UniversityTokyoJapan
  2. 2.Department of Pediatric Surgery, School of MedicineKeio UniversityTokyoJapan
  3. 3.Department of Obstetrics and Gynecology, School of MedicineSt. Marianna UniversityKawasakiJapan

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