Chẩn đoán bất thường đường tiêu hóa thai

CHAN DOAN BAT THUONG

IIUlUIIIl|TIUUWD|

BS NGUHYO EDNONG

BCH HOI VSUM

BCH HSMFM

BAT THUONG DUONG TIEU HOA THAI

FETAL GASTROINTESTINAL TRACT

maine

NI) (00000)

STAT

STATENS

BAT THUONG DUONG TIỂU HOA THUONG GAP

N: l0),

atresia/stenosis

“Teo thyc quan, Teo hep tétrang

Teo hing hitrNondngrt

BC: VPMPSp, rematusrudidetn yde,ath

-Bt (thud hu mon try trang )

1. TEO THUC QUAN (Esophageal Atresia)

US: DD AC sagittal thaylFTS, location, size ( obstruction)

«Da i(thméng > 25), edb: dlabetes, neurologic prob, PRS

+ Da dy small absent

* IUGR & polyhydramnios in 3rd T: alarming combination

Cheat Length Width AP

RR)

9W 0

1, TEO THUC QUAN (Esophageal Atresi}

+ Dau higu ti Pouch sign

1, TEO THUC QUAN Fogel Ar

phan loa Gross -
(Ac EAl no TE (1-8) if
BEN prox EF (2) Ỉ

« C:EA stl TEF Ge) vy
7D: EA+p &dTEF (<1)
Eno BA, TEF (4%)

Prognosis

- AD WGRVACTERL,

- $0% other defects, espTlŸ
-LS, PT, prematurity

Vjayaraghavan, $8, (2019), Sonography of Fatal Gastrointestinal Tract (IT), In: las of Fatal maging, Springer, Singapore

DISTENDED STOMACH loop ( double atresias)

{/ Gastric outlet obstruction T

rare, primary, or secondary due to
vascular insult

2! normal FU Transient

a

#

bị

a

°

“
củ

_)

t4)

Carol, Benson MD

2, TEO TA TRANG (Duodenal Atresia)

*Bong dOi thong nhaulATTCj,ust

right of middle < enlarged stomach

«Tuthhinusaug20-24 fudn

* Da day tang nhu dng

«Dal: 241% vida sb TON3

* Nguy co’ lech boi (T24): 30-40%;

* Assoc anomalies 60%:

+ $0 tc sau bong Vater & Hod tà

Be Thodng qua ? Rupture of web?

Choudhr M.S, Rahman N.; Boyd; Lakhoo K, Duodenal Aresa: Associated Anomals, Prenatal Diagnosis and Outome, Plt Su Int 2008 25, 727-730,

DUODENAL OBSTRUCTION : atresial stenosis
in addit to DA, double bubble can be also...

INSTRINSIC: ATRESIA, STENOSIS WEB
EXTRINSIC: ANNULAR PANCREAS, LADD's BAND,
VOLVULUS, PREDUODENAL PORTAL VEIN

The appliaton of prenatal ultrasound in
‘he diagnosis of congenital duodenal

obstruction

MALROTATION/ left SOMERISM, risk of VOLVULUS, and DUODENAL obstucton DUE 10 LADD's BAND

4, TACHONG-HOI TRANG

Small bowel obstruction

+ Chan dodn US: typically tresl(s), Qual

rudt dan, 2 15mm hodc! vad 7mm

* Vascular insult

+ Da Githutg gap kite ca va > 25
«Tac cag cao cag da Oi nid, som,

it qual ruotgidn

+ 0h jejunum: can dilate alot
+ 43} leum:perforate at smaller diameter
+ 7% both or multiple sites

3, TEO HONG HOLTRANG: Classification? Location, Prognosis: Challenging,

PRENATALLY DINGNOMED AS EJUNAL ATRESIA TURNED OUT TOBE SEVERE LEAL ATRESIA TYPE IB

4,Small bowel obstruction: etiologies challenging...
atresia vascular accident), VOLVULUS, meconium ileus,
intussusception, internal hernia.

VOWULUS

*Soallhoelandpoxmalcdvnit) as

mi \¿

*Falretfationtpmets Lack of peristalsis

ot mon her) or
inesinataesl
+ iyi dic, gi nl i

khan).

my

(S; Colbean sn or Wil

‘glean

tii qh dị

thdoa n en un,
PT ip cu usith

Small bowel obstruction risk of ischemia, infarction perforation

be a: +

(Meconium Peritonits)

EchAsoces,gdsleendend biowelcs =MP
Peeorain canbe sealed spontaneinoeuversy lfeytus
Cealoum uncommon in CF (meconium leus, GB collapsed

1135000: Chemical pean
Mechanical obstruction alresia, volvulus, mirocolon.),

IN-UTERO Vial NFECTCIMVO, NPAR:V'O

Meconum lus < 25%, neal always CF.
16% CF have MP, typically distal $80, absent GB

(0l
tillftatl

} 6 = 100

Prenat Diag 200727; 960-963

Complication:

prematurity, sudden IUFD

Utrasound Obstet Gynecol 2002; 20: 439-446
Fetal duodenal obstructions: increased risk f prenatal sudden

death

BRANTBERG',H-G,K BLAAS' K. A. SALVESEN’

Risokf prenatal deat even when the karyotype is nomal and
no associated anomalies, The cause of bradycardia o systole
may be vagal overacttdyu to the distensionofthe upper
gastrointestinal, 428 prenatal death

UCU is associated with intestinal atresia and sudden

mascive fell hemorage Maybe due to raised levels of

fetal serum ble aci1d0 smm>oll

Umbilical cord ulceraAn tundierodangro:sed

ent

Barkta Maheshwari Maitayee Roy. Shore Agama,

MIDGUT VOLVULUS CAUSING FETAL DEMISE IN UTERO Courtesy of MD Truong q

AQ bi bu GIN Ost Hostal of Da Nang, VN

CHAN DOAN PHAN BIET small or large bowel?

Vit G nga bn rong ob nich Vit trung tam, trong
Cnsloannmeioaters, Increased sW ainiton Ệng ton ng, Kem da 6 mhu dong
wa hypoechole tubular periph nedndnces——rudt, a goal vi Khi dén nhiéu
urns

2, CBPB : honeycomb sign: difuse non obstructive

bowel dilation? Transient diarrhea, CCLD, mild variant of

Hirschprung?

A CDPBTACRUOT: lltlintlụ l0 Ÿ

HIRCHPRUNG' DISEASE |

Thefetus.net »

TRANSIENT LARGE BOWEL COURTESY OF MO PHAM NGC SON

DILATION IN 3rd trimester ,

4, Anorectal malformation: LBO more difficult to detect than $BO

Wide range appearance normal colon
No bowel dltion in many cases
Antenatal detection rte of LBO i low by US < 30%

Hin anh hu én bnh hung

4 ANORECTAL MALFORMATION

Transient Distertion (< 17 w?) of Right Posterior
Located Simain Anal lesa, Moshe
Bronshlen1, Ayala Gover2, Ron Beloosesly 3

PMID: 27879005 DOI: 101002)ou.20406

1)ARM ls antl ates, SO
wb catea om 1-17 th
sl age hovel rf ia

mn libs), ARN 28

ai ia, eur

alan, VACTERLE,I
2)TReURGM aun raed rue,

11000 ve hing a) cc ates,

cat poping pen ca
ang pl pn th gland

itn tus anna v0
palpi ery a,

i iis,

ol wie h ‘ay

Dan Ths