Volvulus

F Cuillier, L Harper, M Mardamootoo

Fabrice Cuillier, MD*; L. Harper, MD**; M. Mardamootoo*

*   Department of Gynecology, Felix Guyon Hospital, Saint-Denis, Reunion, France;

**  Department of Surgery pediatric, Hôpital Félix Guyon, 97400 Saint-Denis, Ile de la Réunion, France.

Case report
A 26-year-old woman (G1P0) with unremarkable history was sent to our department at 32 weeks due to an abnormal cystic structure that was observed within the fetal abdomen.Her biochemical and previous ultrasonographic exams were reported to be normal.Our ultrasonographic examination at 32 weeks revealed polyhydramnios and a cystic mass, with solid intracystic components, localized in the abdominopelvic region (measuring 55 mm x 38 mm).Amniocentesis was also performed with normal result (46, XX). The parents were negative for mucoviscidosis and delta F508 mutations. Maternal serology did not show any signs of viral infection.The patient was admitted to our hospital at 34 weeks due to premature contractions as a consequence of the increasing polyhydramnios. Amniotic fluid drainage was indicated. The newborn was delivered at 36 weeks with normal postnatal adaptation. Exploratory laparotomy revealed ileal atresia with volvulus and perforation of the terminal part of the ileum.

Images 1-9, and video 1: The images and video show a cystic structure with solid intracystic components within the fetal abdomen - the mass turned out to be the volvulus postnatally.

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Image 10: The image shows polyhydramnios accompanying the bowel obstruction.

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Images 11, 12: Postnatal images showing the dilated, obstructed ileal part of the bowels due to the volvulus. 

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