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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

LUQUE-GONZALEZ, Pablo et al. Intestinal duplication and prenatal differential diagnosis of intra-abdominal cysts. Ginecol. obstet. Méx. [online]. 2023, vol.91, n.3, pp.218-225.  Epub May 19, 2023. ISSN 0300-9041.  https://doi.org/10.24245/gom.v91i3.7868.

BACKGROUND:

Duplications of the digestive tract are a rare variant of congenital malformation that can occur anywhere in the digestive tract. Although improved ultrasound equipment has increased the diagnostic rate, only 30% are diagnosed before birth. The differential diagnosis of intra-abdominal cystic lesions is broad and includes, for example, cysts of the ovary, common bile duct, mesentery or meconium pseudocysts. Treatment is surgical by resection and restoration of intestinal continuity.

CLINICAL CASE:

32-year-old patient, with a previous pregnancy and in the second trimester of the current pregnancy, with suspicion of an intestinal duplication cyst. The genetic study did not reveal any abnormality. The lesion, of tubular cystic morphology, progressively increased in size as the weeks of pregnancy progressed. Induction of labour was indicated in week 39 due to insulin-dependent gestational diabetes. An asymptomatic male was born by euthecological delivery, without complications. Abdominal ultrasound, nuclear magnetic resonance imaging and intestinal transit study of the early neonatal period confirmed the suspected prenatal diagnosis. By means of exploratory laparoscopy, at two weeks of life, resection of the defect was performed, which was reported as: ileal intestinal duplication, without communication with the intestinal lumen. The postoperative course was favourable.

CONCLUSIONS:

Prenatal diagnosis of duplication cysts in the digestive tract is increasing due to improved prenatal diagnostic techniques. Multidisciplinary assessment is crucial to ensure adequate medical surveillance of the pregnancy and the newborn.

Keywords : Ovary; Mesentery; Meconium; Intestinal; Intestinal duplication; Insulin; Gestational diabetes; Laparoscopy.

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