Moshe Bronshtein, MD, Inna Naroditsky, MD.
This was a low risk pregnancy with normal ultrasonographic examination at 16 weeks. At 19 weeks the ultrasound showed dilated fetal bowels with hyperechoic walls. The parents opted for the termination of the pregnancy. Following pathological study found internal transmesenteric hernia of the small intestine.
Spectrum of pathomechanisms leading to fetal bowel dilatation is wide. The internal bowel herniation should also be taken into consideration in differential diagnostic process when dilated fetal bowels are present.
Video 1: 19 weeks of gestation; the video shows dilated, hypoperistaltic fetal bowels with hyperechoic walls. The part of the bowels in center of the dilated loops probably represents the entrapped loop of the intestine in mesenteric defect, which was later confirmed by the autopsy.