Intrauterine midgut volvulus without malrotation: Diagnosis from the ‘coffee bean sign’

Park, Jun Seok; Jae, Seong; Kim, Beom Gyu; Kim, Yong Seok; Choi, Yun-Sang; Chang, In Taik; Kim, Gwang Jun; Lee, Woo Seok; Kim, Gi Hyeon

doi:10.3748/wjg.14.1456

Cited by 43 publications

(60 citation statements)

References 13 publications

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“…This is a segmental dilatation of a bowel loop which resembles a whirl in water. Another characteristic sign of volvulus is a 'coffee bean sign' which is a dilatation of a very short segment of bowel which resembles a coffee bean [7] . Other findings suggestive of congenital volvulus on prenatal ultrasound are: intestinal dilatation, polyhydramnios, intraperitoneal calcification, ascites and fetal hydrops [1,[7][8][9] .…”

Section: Discussionmentioning

confidence: 99%

“…Another characteristic sign of volvulus is a 'coffee bean sign' which is a dilatation of a very short segment of bowel which resembles a coffee bean [7] . Other findings suggestive of congenital volvulus on prenatal ultrasound are: intestinal dilatation, polyhydramnios, intraperitoneal calcification, ascites and fetal hydrops [1,[7][8][9] . Intestinal dilatation and polyhydramnios in congenital volvulus have been described by Molvarec et al [1] , Jequier et al [8] and Has and Gunay [6] .…”

Section: Discussionmentioning

confidence: 99%

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Congenital Midgut Volvulus Associated with Fetal Anemia

Kornacki

Monika²,

Błaszczyński

et al. 2010

Fetal Diagn Ther

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Congenital volvulus is a life-threatening condition, both for the fetus and for the newborn. A volvulus is a twist of small bowel loops or a proximal part of the colon around the mesenteric artery or its branches. The potential consequences of volvulus are ileus and necrosis of the intestinal wall. Prenatal diagnosis of midgut volvulus is difficult. It should be suspected antenatally when polyhydramnios, intestinal dilatation, ascites and/or signs of fetal anemia are present on ultrasound assessment. We report a case of a congenital midgut volvulus associated with fetal anemia. The fetal ultrasound performed at 32 weeks’ gestation showed a polyhydramnios, hydrothorax, thick ascites accumulation around the liver and the suspicion of a dilated bowel loop. Additionally, Doppler examination showed an increased value of peak systolic velocity in the middle cerebral artery. Cordocentesis confirmed significant fetal anemia. At 34 weeks, because of the suspicion of idiopathic meconium ileus and secondary anemia, a Cesarean section was performed after the administration of steroids. During the laparatomy, performed postnatally, a midgut volvulus was diagnosed. The affected portion of the ileum was resected and end-to-end anastomosis performed. An antenatal diagnosis of midgut volvulus should be considered when signs of fetal anemia, including an increased value of peak systolic velocity in the middle cerebral artery, are present with polyhydramnios, fetal ascites, dilated bowel loops on antenatal ultrasound. An assessment of the fetal hemodynamic status should be a part of the ultrasound assessment for patients with nonspecific fetal bowel pathologies, including congenital volvulus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Congenital Midgut Volvulus Associated with Fetal Anemia

Kornacki

Monika²,

Błaszczyński

et al. 2010

Fetal Diagn Ther

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“…In our cohort study, 4 volvulus cases were detected antenatally and confirmed at birth, of whom 3 died after birth. Prenatal sonographic findings such as dilated bowel loops, the ‘whirlpool sign' (twisting of bowel loops around the mesenteric artery) and the ‘coffee bean sign' (distention of a very short segment of bowel which resembles a coffee bean) are compatibles for intestinal volvulus [43,44] (fig. 2).…”

Section: Discussionmentioning

confidence: 99%

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Martillotti

Boucoiran²,

Damphousse³

et al. 2015

Fetal Diagn Ther

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Introduction: The objective of the study was to establish the predictive value of prenatal ultrasound markers for complex gastroschisis (GS) in the first 10 days of life. Material and Methods: In this retrospective cohort study over 11 years (2000-2011) of 117 GS cases, the following prenatal ultrasound signs were analyzed at the last second- and third-trimester ultrasounds: intrauterine growth restriction, intra-abdominal bowel dilatation (IABD) adjusted for gestational age, extra-abdominal bowel dilatation (EABD) ≥25 mm, stomach dilatation, stomach herniation, perturbed mesenteric circulation, absence of bowel lumen and echogenic dilated bowel loops (EDBL). Results: Among 114 live births, 16 newborns had complex GS (14.0%). Death was seen in 16 cases (13.7%): 3 intrauterine fetal deaths, 9 complex GS and 4 simple GS. Second-trimester markers had limited predictive value. Third-trimester IABD, EABD, EDBL, absence of intestinal lumen and perturbed mesenteric circulation were statistically associated with complex GS and death. IABD was able to predict complex GS with a sensitivity of 50%, a specificity of 91%, a positive predictive value of 47% and a negative predictive value of 92%. Discussion: Third-trimester IABD adjusted for gestational age appears to be the prenatal ultrasound marker most strongly associated with adverse outcome in GS.

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“…In many cases, non-specific features, such as distended bowel loops, ascitis or hydramnios with normal position of mesenteric vessels were described on fetal ultrasound scans or MRI. In few studies the diagnosis of volvulus without malrotation was advanced when ultrasound scan revealed a long segment of bowel loops which formed a mass with a typical whirlpool or snail configuration, whereas others reported the ‘coffee bean sign’ 3 8 9. Like in our cases, some authors had reported that the appearance of a curved anechoic mass was a suggestive sign of segmental volvulus 3 8…”

Section: Discussionmentioning

confidence: 51%

Prenatal intestinal volvulus: look for cystic fibrosis

et al. 2016

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Intestinal volvulus is a life-threatening emergency requiring prompt surgical management. Prenatal intestinal volvulus is rare, and most are secondary to intestinal atresia, mesenteric defect or without any underlying cause. Cystic fibrosis (CF) is known to cause digestive tract disorders. After birth, 10-15% of newborns with CF may develop intestinal obstruction within a few days of birth because of meconial ileus. This obstruction is a result of dehydrated thickened meconium obstructing the intestinal lumen. We report two cases of fetuses with prenatal diagnosis of segmental volvulus in whom CF was diagnosed.

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Intrauterine midgut volvulus without malrotation: Diagnosis from the ‘coffee bean sign’

Cited by 43 publications

References 13 publications

Congenital Midgut Volvulus Associated with Fetal Anemia

Congenital Midgut Volvulus Associated with Fetal Anemia

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Prenatal intestinal volvulus: look for cystic fibrosis

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