Bladder outlet obstruction causes fetal enterolithiasis in anorectal malformation with rectourinary fistula

Journal of Pediatric Surgery
Udo RolleHolger Till

Abstract

Extraluminal calcified meconium is found frequently by prenatal ultrasound in cases with bowel perforation and meconium peritonitis. Intraluminal intestinal meconium calcifications are rarely seen in prenatal sonography. Meconium calcifications result from a mixture of meconium and urine that indicates a connection between intestinal and urinary tract. We report a case of a male newborn prenatally diagnosed with intraluminal echogenic calcifications at 23 weeks of gestation, suggesting an anorectal malformation (ARM) with rectourinary fistula. At birth, the child presented with a complex ARM including high anal atresia with both perineal and rectourethral fistula. Furthermore, a bladder outlet obstruction due to a urethral stenosis was diagnosed. Vesicostomy was performed as an emergency procedure followed by colostomy during neonatal period. Posterior sagittal anorectoplasty was performed at the age of 4 months. Prenatal echogenic calcifications within bowel should raise the suspicion of ARM with rectourinary fistula and bladder outlet obstruction.

References

Aug 1, 1990·American Journal of Medical Genetics·S Shen-Schwarz, R Fitko
Jun 1, 1988·Journal of Pediatric Surgery·J P MillerK Sukarochana
Aug 5, 2006·Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology·A Pohl-SchickingerD Hüseman

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Citations

Mar 24, 2010·Pediatric Surgery International·Jonathan LopaterPascal de Lagausie
Apr 14, 2009·Journal of Pediatric Surgery·Robert Bergholz, Katharina Wenke
Nov 29, 2015·Seminars in Ultrasound, CT, and MR·Maria A Calvo-Garcia
Mar 4, 2017·Ultrasound Quarterly·Patricia CorreiaGonçalo Inocêncio
Mar 13, 2018·AJR. American Journal of Roentgenology·Anh-Vu NgoGrace S Phillips
Mar 18, 2019·Fetal Diagnosis and Therapy·Michael R MallmannUlrich Gembruch

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