This is a case of a healthy 27-year-old G1 P0 who was presented to our department at 23 weeks of gestation. She had non-contributive family or personal history. She was referred from another center for a suspicion of spina bifida.

Our ultrasound examination revealed the following findings:

Our differential diagnosis included Omphalocele-Exstrophy-Imperforate anus-Spinal defects, OEIS complex. Patient decided for the pregnancy termination. Autopsy examination confirmed our ultrasound findings and described anal atresia as well.

Images 1,2: Image 1 shows an axial view, note the "banana" sign and abnormal appearance of the posterior fossa. Image 2 shows a mass protruding form the abdominal wall, located between the legs of the fetus.