Fabrice Cuillier, MD*; L. Lagarde, MD**; E. Eyssartier, MD***.

*      Department of Gynecology, Hôpital Félix Guyon, 97400 Saint-Denis, Ile de la Réunion, France.
**     Department of Gynecology, Hôpital Gabriel Martin, 97400 Saint-Paul, Ile de la Réunion, France.
***    Department of Pediatric surgery, Hôpital Félix Guyon, 97400 Saint-Denis, Ile de la Réunion.

Case report
   
A 35 year-old woman with a non-contributive history presented to our unit at 31 weeks of pregnancy. Her ultrasonographic examination revealed several anomalies of the fetus:

• Double bubble sign suggesting duodenal atresia;

• Abnormal jejunal dilatation;

• A few findings were suspicious of aneuploidy - thin umbilical cord with the lack of coiling, bilateral "sandal gap" of the feet, bilateral wrist contraction with the same position of the fingers during the series of several examinations.

An amniocentesis was normal (46, XX). The fetus was delivered at 36 week and underwent the operation during which the diagnosis of duodenal and proximal jejunal atresia was confirmed.

Images 1, 2: Sagittal and transverse scans of the fetal abdomen showing the proximal intestinal dilatation.

Images 3, 4: Transverse scans of the fetal abdomen showing the proximal intestinal dilatation ("double bubble" sign).

Images 5, 6: The image 5 shows the thin umbilical cord vit lack of coiling. The image 6 shows the "sandal gap" of the left fetal foot.

Images 7, 8: The fingers of the fetus were in this position during several examinations.

Images 9, 10: The images show peroperative images of the duodenal atresia.