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Radiology
Intestinal Obstruction
Built from Obstetric Imaging
What’s inside
11 sections · 130 slides
Overview
- Why anyone looks at the fetal gut
- Where a block can sit, top to bottom
- The two findings that start every diagnosis
- What this deck covers
Oesophageal Obstruction
The food pipe ends in a blind pouch instead of reaching the stomach
- What oesophageal obstruction is
- How common it is and why it happens
- How the split going wrong shows on a scan
- Which pattern is the common one
- How to read the type table
- Different Types of Esophageal Atresia
- Different Types of Esophageal Atresia (continued)
- What the newborn shows
- What the scan can show
- Small stomach, excess fluid and a blind upper pouch
- How well ultrasound performs
- A small fetus is part of the picture
- A missing stomach is not always abnormal
- Testing the amniotic fluid
- What MRI adds
- “
- Other reasons the stomach is not seen
- A fetus that does not move does not swallow
- What else is wrong in these babies
- The VACTERL association
- Outlook after birth
- Where the harm comes from
Gastric Obstruction
The stomach fills but its exit will not open
- What gastric outlet obstruction is
- Why the pylorus fails
- How it shows up
- What travels with it
- Antral webs
- Treatment
Duodenal Obstruction
Two fluid bubbles in the upper abdomen, and what they mean
- What duodenal obstruction is
- Why the duodenum blocks
- The chromosome link
- What the newborn shows
- The double-bubble sign
- Two bubbles before and after birth
- The C-shaped sign
- C-shaped fluid collection in the upper abdomen
- What MRI adds
- The trap: a false double bubble
- Treatment and outlook
Jejunal and Ileal Obstruction
The commonest cause of newborn bowel obstruction
- What jejuno-ileal atresia is
- Why the small bowel closes off
- Where the block sits
- What the newborn shows
- What the scan shows
- Massively dilated small bowel loops
- What MRI adds
- What else looks like this
- What travels with small bowel atresia
- Outlook, and the apple peel bowel
- Apple peel bowel with ascites and bright bowel
- The apple peel outlook
Imperforate Anus
The exit of the gut never opens
- Large bowel anomalies
- How the anus forms, and fails
- Two families of anorectal malformation
- High versus low
- What the scan shows
- Telling the calcifications apart
- Other clues before birth
- Bowel stones in a blind-ending fetal rectum
- What travels with imperforate anus
- Treatment and outlook
Hirschsprung Disease
A segment of bowel with no nerve cells cannot relax
- What Hirschsprung disease is
- Why the nerve cells are missing
- The genetics
- What the newborn shows
- How much bowel is affected
- Why the fetal scan usually misses it
- Meconium-filled colon on fetal MRI
- What travels with Hirschsprung disease
- Treatment and outlook
Volvulus
Bowel that twists on its own blood supply
- What volvulus is
- The mechanics of the twist
- From twist to disaster
- What it does to fetus and newborn
- What the scan shows
- The whirlpool sign
- The barber pole sign
- Twisted bowel at 33 weeks
- Other tests, and what to do
Echogenic Bowel
Bowel that looks too bright, and what that is worth
- What echogenic bowel means
- Bowel as bright as bone
- How often it is seen
- What bright bowel has been linked to
- Why bowel goes bright
- How to look for it properly
- What it turns out to be
- What to do about it
Meconium Ileus and Peritonitis
Sticky first stool that plugs the gut and can burst it
- Meconium, ileus and peritonitis
- From sticky meconium to peritonitis
- The cystic fibrosis link
- What the scan shows
- Confirming and imaging it
- Meconium peritonitis at 25 and 35 weeks
- What else looks like this
- Treatment and outlook
- What cystic fibrosis still costs
Putting It Together
Level of the block, associated disease, and what to tell the referrer
- High blocks versus low blocks
- How to read the ultrasound features table
- Ultrasound Features of Common Gastrointestinal Abnormalities
- What the referring physician needs to know
- Key points, part one
- Key points, part two
- Suggested readings
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- References (continued)
- Obstetric Imaging: Fetal Diagnosis and Care, 2nd Edition