The application of prenatal ultrasound in the diagnosis of c
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Congenital duodenal obstruction (CDO) is a common congenital malformation of the digestive tract with an incidence rate of approximately 1/2500–1/10000 and is caused by endogenous and exogenous factors. The endogenous factors refer to the blocking, narrowing, or disconnection of the duodenum due to fetal defects in the development of the foregut. Most of the exogenous factors are caused by the annular pancreas, duodenal network, volvulus, malrotation of the small intestine, intestinal atresia, rare duodenal duplication or anterior duodenal vein.

In this study, a retrospective analysis of 40 patients diagnosed with CDO was carried out. Data on the diagnosis, ultrasound images, and outcomes of the patients were gathered, and the features of the patients were analyzed. The results showed that there were 17 patients (42.5%) of congenital duodenal diaphragm, all with a ‘rat tail’ sign on the ultrasound images. Moreover, there were 4 patients (10.0%) of CDO caused by annular pancreas, all with a ‘pliers’ sign on the ultrasound images.

This study mainly focused on the ultrasound characteristics of CDO and reached the following conclusions:

(1) The ‘rat tail’ sign could be used as an indirect ultrasound feature in the diagnosis of the congenital duodenal diaphragm;

(2) The ‘pliers’ sign could be used as a direct ultrasound feature in the diagnosis of CDO caused by the annular pancreas;

(3) Down syndrome did not affect the incidence rate of duodenal obstruction.

However, the clinical diagnosis of the duodenal diaphragm and annular pancreas by using the ultrasound characteristics of the ‘rat tail’ sign and the ‘pliers’ sign requires the operator to have a deep understanding of these two diseases and the instrument to have a high resolution. Regarding the other causes of CDO, this study could not draw a conclusion because of the limited samples.

Source: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03078-5
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