We should at this point have a solid understanding of Gatroschisis vs Omphaloceles- so lets use this thread to talk about the other anomalies we may run across-
Discussion Board Week 7.............
Abdomen and urinary System Thoughts
Re: Abdomen and urinary System Thoughts
Question.
If the stomach is supposed to be on the left and the gallbladder is on the right.. and this is slightly below the AC..and the UV is the umbilical vein..how is the GB so close to it and on the same side of the bladder? So is this normal or abnormal? And if it is abnormal how did they know it is the GB? We're supposed to remember that the GB is on the right to not mistake it for pathology..
How are you ladies looking at this?
Re: Abdomen and urinary System Thoughts
Hi Jackie,
Im not sure the correct answer, but I would think it can look like it’s towards the left because there are many variations of how the GB lies. So this may be abnormal because its a GB variatio??Also I would put color on it to make sure it’s not a part of the umbilical vein and that it is in fact the fetal GB.
Re: Abdomen and urinary System Thoughts
I agree with what Amanda wrote. Investigate, image in multiple panes, and add color. The gallbladder is mobile to a certain degree so depending on babies anatomy and movement the gallbladder could be shifted. Although, I also haven't seen a gallbladder that close to the skinline on fetus before. Interesting question!
Re: Abdomen and urinary System Thoughts
I decided to look up issues with the bowel. Echogenic bowel is a marker for cystic fibrosis, which is the most common lethal genetic disorder for caucasians.
This case from the fetus.net followed a set of twins. One showed early signs of echogenic bowel/cystic fribrosis. There were many complications including ascites and both twins had poly and oligohydramnios at differing times throughout gestation. Twin B also ended up showing a mechonium pseudocyst later in gestation. I know I am still learning to throughly assess the fetal abdomen/bowel. For now it takes me at least the full hour just to get all of my images and focus on big eye catching pathology.
As Michelle stated in lecture echogenic bowel is something we notice more and more as technology has improved, and is not always a marker for cystic fibrosis or Down's, but it is still something to be aware of.
These are from older machines, but I think we can still appreciate the pathology in these images.
This is at weeks showing the meconium pseudocyst
Re: Abdomen and urinary System Thoughts
Another abdominal anomaly we may come across is Duodenal Atresia.
Definition: congenital maldevelopment or absence of the proximal portion of the small bowel (duodenum)
Sono: "Double Bubble" sign (dilated, fluid-filled anechoic stomach and proximal duodenum), Polyhydramnios, IUGR
Associated with: Trisomy 21, esophageal atresia, VACTERL, cardiac anomalies
(source: ABD & OBGYN Review Book by Steven Penny)
22 year old patient (G1P0), these findings were found during a routine 20 week ultrasound study. (source: thefetus.net)
