1
|
Chelu SC, Kundnani NR, Nistor D, Chiriac VD, Brad GF, Cerbu S, Iancu MA, Borza C. Importance of Prenatal Diagnosis of Ileal Atresia in Gestational Diabetes Cases. AMERICAN JOURNAL OF CASE REPORTS 2024; 25:e942838. [PMID: 38584385 PMCID: PMC11009888 DOI: 10.12659/ajcr.942838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/25/2024] [Accepted: 02/16/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Maldevelopment of the fetal bowel can result in the rare condition of intestinal atresia, which results in congenital bowel obstruction. This report describes a case of prenatal diagnosis of fetal ileal atresia at 22 weeks' gestation. CASE REPORT Here, we present a 24-year old woman who was 22 weeks into her first pregnancy when she underwent routine fetal ultrasound. She was diagnosed with gestational diabetes mellitus. Her body mass index was normal and she had normal weight gain. The ultrasonographic examination performed revealed a hyperechoic bowel and a small dilatation of the bowel. The couple was counselled for possible intestinal atresia and its postnatal implications. At 33 weeks of gestation, polyhydramnios appeared, and the intestinal distension was much more pronounced, with hyperechoic debris in the intestinal lumen (succus-entericus). After birth, surgery was performed and we concluded the patient had type II atresia, which was surgically treated. CONCLUSIONS This report has highlighted the importance of antenatal ultrasound in detecting fetal abnormalities, and has shown that rare conditions such as intestinal atresia can be accurately diagnosed and successfully managed. Surgical correction, if implemented promptly after stabilizing the general condition, can have a relatively good prognosis. Coexisting fetal ileal atresia and gestational diabetes mellitus are rare occurrences, which can make each condition even more difficult to treat.
Collapse
Affiliation(s)
- Sorina Cristina Chelu
- Department of Functional Science, Discipline of Pathophysiology, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Center for Translational Research and Systems Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Discipline of Obstetrics and Gynecology, “Victor Babeş” University of Medicine and Pharmacy Timişoara, Timişoara, Romania
| | - Nilima Rajpal Kundnani
- Department of Cardiology – Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Research Centre of Timişoara Institute of Cardiovascular Diseases, Timişoara, Romania
| | - Daciana Nistor
- Department of Functional Sciences, Physiology, Centre of Immuno-Physiology and Biotechnologies (CIFBIOTEH), “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Oncogen, Centre for Gene and Cellular Therapies in Cancer, Timişoara, Romania
| | - Veronica Daniela Chiriac
- Discipline of Obstetrics and Gynecology, “Victor Babeş” University of Medicine and Pharmacy Timişoara, Timişoara, Romania
| | - Giorgiana Flavia Brad
- Department XI of Pediatrics, 1 Pediatric Discipline, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, România
- 1 Pediatric Clinic, “Louis Ţurcanu” Children’s Clinical and Emergency Hospital,Timişoara, România
| | - Simona Cerbu
- Discipline of Radiology and Medical Imaging, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
| | - Mihaela Adela Iancu
- Department 5, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Claudia Borza
- Department of Functional Science, Discipline of Pathophysiology, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Center for Translational Research and Systems Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Centre of Cognitive Research in Pathological Neuro-Psychiatry NEUROPSY-COG, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
| |
Collapse
|
2
|
Attoun MA, Albalawi SMD, Ayoub A, Alnasser AK, Alkaram EH, Khubrani FA, Alzahrani KJ, Alatawi KA, Almutairi N, Alnami AG. The Management of Intussusception: A Systematic Review. Cureus 2023; 15:e49481. [PMID: 38152810 PMCID: PMC10752083 DOI: 10.7759/cureus.49481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
Intussusception (ISN) is a dangerous condition where a portion of the intestine slides into an adjacent area of the intestine. This telescoping motion frequently prevents liquids or food from flowing through. Developing management guidelines for ileocolic (IC) intussusception was the aim of this systematic study. Data sources were PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Scopus, and Embase databases. Our review investigated English-language articles (from 2010 to 2023) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Overall, there were 15 articles. Surveys and analyses of national databases were the most widely used methods (n=15). The search identified 561 studies; 15 were eligible for inclusion in the analysis. Further understanding of the management of intussusception may help improve evaluation and management in the future. The use of preventive antibiotics does not reduce problems following radiologic reduction. When clinically appropriate, repeated attempts at enema reduction may be made. After the enema reduction of ileocolic intussusception, patients can be safely watched in the emergency room (ER), thereby avoiding hospitalization. Success rates for laparoscopic reduction are high. When it comes to intussusception in children who are hemodynamically stable and do not have a serious illness, there is no need for pre-reduction antibiotics. Prioritizing nonoperative outpatient (OP) therapy is recommended as the primary approach, with the utilization of minimally invasive procedures to avoid the necessity for laparotomy. The management of colonic intussusception involves complete removal in one piece, while enteric intussusception can be addressed through reduction followed by resection. A targeted approach is recommended, recognizing the intermediate forms of intussusception that may exist between the colonic and enteric types. It is essential to note that the prevailing treatment for adult intussusception remains to be surgical intervention.
Collapse
Affiliation(s)
- Majed Ali Attoun
- Department of Surgery, King Salman Armed Forces Hospital, Tabuk, SAU
| | | | - Afnan Ayoub
- Faculty of Medicine, Batterjee Medical College, Jeddah, SAU
| | - Ali K Alnasser
- Faculty of Medicine, Medical University of Lodz, Lodz, POL
| | - Esraa H Alkaram
- Department of Emergency Medicine, Almana Group of Hospitals (AGH), Dammam, SAU
| | | | - Khalid J Alzahrani
- Department of Radiology, Imam Abdulrahman Bin Faisal University, Dammam, SAU
| | | | | | | |
Collapse
|