ANTENATAL FINDING OF INTESTINAL-OBSTRUCTION CAUSED BY ISOLATED SEGMENTAL JEJUNAL DILATATION - A CASE-REPORT

The authors report a case of segmental jejunal dilatation that was dis covered antenatally and manifested clinically as lower obstruction in a newborn boy. The antenatal ultrasound findings at 29, 30, and 31 wee ks' gestation showed a constant hypoechogenic image (6 x 3 cm in diame ter) localized to the right flank of the fetal abdomen, thought to be situated in the right colon. A prenatal diagnosis of incomplete right colonic stenosis was considered. In the immediate postnatal period, th ere were clinical manifestations of intestinal obstruction; however, r esults of a contrast enema and rectal biopsies were normal. An upper g astrointestinal contrast study showed a dilated jejunal loop situated approximately 15 cm from the ligament of Treitz. During surgery, a lar ge dilated jejunal loop (7 cm in diameter, 15 cm in length) was found and resected. Histopathologic examination confirmed the diagnosis of s egmental jejunal dilatation. This is the first antenatal illustration of this rare pathology, and it supports the hypothesis of a congenital origin for this anomaly. Copyright (C) 1996 by W.B. Saunders Company