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Master Thesis

Imagerie anténatale, corrélation et devenir post-natal des foetus porteurs d’une dilatation digestive du grêle à l’anus : à propos d’une série rétrospective de 17 cas au CHU de Bordeaux

Abstract : Objective: the main objective of our study was to evaluate the relevance of prenatal diagnoses about prenatal bowel dilatations, thanks to postnatal data. The secondary objectives were to observe the mortality and morbidity of these neonates. Methods: this is an observational restrospective monocentric study, about prenatal digestive dilatations between January 1st 2010 to December 31st 2016 in our tertiary care hospital in Bordeaux, France. Prenatal imaging data has been compared with postnatal surgical peroperative findings, and the outcome of neonates has been observed up to 6 months. Results: 17 cases have been included and splitted into groups according to the postnatal diagnosis: 2 cases of duodenal stenosis, 4 of small bowel atresia, 5 of small bowel volvulus, 3 cases of gastroschisis and 3 cases of large bowel obstruction. For duodenal stenosis, a systematic MRI exam, could be discussed. For small bowel atresias and volvulus, prenatal distinction is difficult between those two entities and proper detection of multiples atresias is not achievable nowadays. However, MRI is reliable to determine the level of the obstacle, with a concordance of 7 out of 9 cases. In case of a gastroschisis, we do think that a prenatal dilatation predicts an associated bowel atresia, with a level of obstruction that MRI can determine. For large bowel obstacles, we do emphasize that echographic examination of the anal sphincter complex in US and a complete prenatal check-up are mandatory. We have 2 cases of correct prenatal diagnoses, and both of them were part of a syndrome, confirmed postnatally. Conclusion: determination of the level of obstruction and detection of digestive complications is reliable thanks to MRI. However, detection of multiples atresias and the analysis of the remaining distal bowel, critical informations in volvulus and complex gastrochisis, have yet to be improved.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01552101
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Friday, June 30, 2017 - 6:14:30 PM
Last modification on : Friday, November 8, 2019 - 6:45:25 PM
Long-term archiving on: : Monday, January 22, 2018 - 10:24:02 PM

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Fabien Ho-Mouye. Imagerie anténatale, corrélation et devenir post-natal des foetus porteurs d’une dilatation digestive du grêle à l’anus : à propos d’une série rétrospective de 17 cas au CHU de Bordeaux. Médecine humaine et pathologie. 2017. ⟨dumas-01552101⟩

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