1. Gastrointestinal Anomalilerin Prenatal Tanisi
Serdar H. Ural, M.D., F.A.C.O.G.
Director, Division of Maternal Fetal Medicine
Director, Fellowship Training Program
Medical Director, Labor and Delivery Unit
Director, Obstetrical Ultrasound Unit
Professor of Obstetrics & Gynecology and Radiology
PennStateHealth University College of Medicine

2. Anatomi/Fizyoloji 5-12. hafta embriyogenez Mide Yutkunma refleksi
Intestinal peristalsis
Mekonyum
Urogenital sinus
Rektum

3. Duodenal Atrezi

4. Duodenal Atrezi
-Duodenum tikanmasi
-En sik konjenital ince bagirsak atrezisi
-1/10,000 dogum, hafta embriyogenez
-Diger anomaliler, kromozom, genetik
-Down sendrom-%30
-Prognoz, cerrahi-diger hersey normalse iyi
-Double bubble
-Mide bosalmaz
-Polihidramniyoz

5. Duodenal Atresia+ polyhydramnios 31w GA: Maternal IDDM and T 21

6. Doudenal Atresia

7. #2

8. #2
Same patient close to the end of the exam.

9. Duodenal Atresia and Fetal Vomiting

10. Ince Bagirsak Atrezisi, Mekonyum Ileus
Jejuno-ileal stenoz, volvulus
Vaskuler
Kistik fibroz-%25
Bagirsak dilatasyonu
Polihidramniyoz

11. Small Bowel Obstruction Bowel Atresia
The sites of small bowel atresia are:
Proximal jejunum (31%)
Distal jejunum (20%)
Proximal ileum (13%)
Distal ileum (36%)
More than one site involved (6%).

12. Dilated Fetal Bowel

13. Gastrosizis -Paraumbilikal duvar defekti -1/4000 dogum
-Cogu zaman bagirsak sag taraf defektinden cikar
-Kromozom riski az, ama sifir degil
-Rupture omfalosel ihtimali
-IUGG
-Prognoz, cerrahi, iyi

14. Gastroschisis

15. Gastroschisis

16. Gastroschisis

17. Gastroschisis

18. Dilated external bowel

19. Omfalosel -Membran icinde bagirsak protruzyonu
-Abdominal duvar defekti-umbilikal kord cikis
-1/4000
-Karaciger %80
-%60-70 diger anomaliler
-%20-30 kromozom
-Beckwith-Wiedemann sendromu; makrozomi
-13. haftaya kadar fizyolojik herniyasyon
-Prognoz

20. Omphalocele

21. Omphalocele

22. Omphalocele

23. Omphalcele

24. Omphalocele

25. Omphalocele

26. Omphalocele

27. Omphalocele

28. Echogenic Bowel

29. Echogenic Bowel

30. Echogenic Bowel

31. Echogenic Bowel

32. Mekonyum Peritonit/Kist
Steril kimyasal/enflamasyon sonucu bagirsak perforasyonu
Obstruksyona bagli
Mekonyumun cikisi iritasyon sonucu kiste (kompleks gorunum olabilir) yol acar
Kistik fibroz
Vaskuler
Polihidramniyoz bulunur
Cogu zaman kendiliginden gecer, bazen cerrahi

34. US at 27w
MR at 28w
Complex cyst with fluid- fluid level

35. Enterik Duplikasyon Kisti
Herhangi bagirsak bolgesi
Tubuler
1’den fazla
Postnatal US: duodenal duplication cyst

36. Mezenterik/Omental Kist
Abdominal lenfatik malformasyon
Buyuk multilokuler kistik yapi
Kompleks gorunum
Vaskuler goruntu

37. Mesenteric Cyst LUQ (Vascular Malformation, Lymphatic Type)

38. Anal/Kolon/Kloakal Atrezi
Iskemi
1/500
Genetik
VACTERL birlesimi; vertebral defekt, anal atrezi, trakeoozofagal fistul, renal displazi
Alkol, diyabet
Prognoz %90

39. Persistent Cloaca US Prenatal Diagnosis

40. Colonic Atresia
Dilated bowel (1st detected at 23w US). Echogenic content and haustral pattern to level of expected distal transverse colon. AFI was normal (18.7cm at 30w)

41. Colonic Atresia

42. Intraluminal Kalsifikasyon

43. Case #6

44. Case #6
Bladder
Normal mesane mevcut

45. -Ultrason oldukca faydali -Tani deneyimli ellerde emin
GI Anomaliler
-Ultrason oldukca faydali
-Tani deneyimli ellerde emin
-Tarama/invaziv yontemler kesin teshis
-Ultrason takibi cok onemli; komplikasyon taramasi (polihidramniyoz); dogum zamanlamasi
-Hasta danismanligi