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Prenatal diagnosis of esophageal, gastrointestinal, and anorectal atresia

Author
Dorothy I Bulas, MD
Section Editors
Deborah Levine, MD
Louise Wilkins-Haug, MD, PhD
Deputy Editor
Vanessa A Barss, MD, FACOG

INTRODUCTION

Congenital atresia of the esophagus, small or large bowel, or anorectum results in partial or complete obstruction, which may have clinical manifestations in utero. The ability to diagnose these atresias prenatally is influenced by the site of obstruction, the presence of associated anomalies, and the gestational age at the time of imaging.

This topic will discuss prenatal evaluation and obstetrical management of fetal esophageal, small/large bowel, and anorectal atresia. Postnatal clinical manifestations, diagnosis, evaluation, and management are reviewed separately. (See "Congenital anomalies of the intrathoracic airways and tracheoesophageal fistula" and "Intestinal atresia" and "Congenital aganglionic megacolon (Hirschsprung disease)".)

IMAGING THE FETAL GASTROINTESTINAL TRACT

Normal ultrasound findings — Normal ultrasound findings of the various parts of the fetal gastrointestinal system depend on the gestational age at examination.

Esophagus — The normal fetal esophagus is collapsed and typically not visualized throughout pregnancy. The amount of fluid in a swallow is too small to be seen in the esophagus unless fluid accumulates because of an atresia or stricture.

Stomach — A fluid-filled stomach should be detectable sonographically in most second- and third-trimester fetuses since the fetus begins to swallow amniotic fluid by 11 to 14 weeks of gestation.

                                 

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Literature review current through: Nov 2016. | This topic last updated: Thu Oct 13 00:00:00 GMT 2016.
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