Ch 62 The Fetal Abdomen

Question 1

Remnant of the proximal part of the yolk sac that fails to degenerate and disappear in early fetal life

Answer 1

Meckel’s diverticulum

Question 2

The stomach should be seen by > ___-____ weeks

Answer 2

> 14-16 weeks

Question 3

Echogenic debris in the stomach may represent what? (3)

Answer 3

1. Vernix
2. Protein
3. Intra-amniotic hemorrhage

Question 4

Left portion of the transverse colon, descending colon, sigmoid colon, rectum, superior portion of the anal canal, epithelium of bladder, and most of the urethra

Answer 4

Hindgut

Question 5

The hindgut is supplied by the _______

Answer 5

Inferior mesenteric artery

Question 6

What is the least common problem for no visualization of the stomach?

Answer 6

Esophageal anomalies

Question 7

An abdominal circumference is taken at the level of the ______ and umbilical portion of the _______

Answer 7

Portal sinus / umbilical portion of the left portal vein

{the hockey stick}

Question 8

Meconium begins to accumulate by ___-___ weeks

Answer 8

> 15-16 weeks

Question 9

After ____ weeks the distinction between small from large bowel can be made

Answer 9

20 weeks

Question 10

After _____ weeks peristalsis may be observed

Answer 10

27 weeks

Question 11

The diameter of small bowel lumen is less than or equal to ____ mm

Answer 11

5mm {this is normal}

Question 12

By 11 weeks the fetal liver is ___% of the total weight of the fetus

Answer 12

10%

Question 13

At term the liver is ___% of the total weight of the fetus

Answer 13

5%

Question 14

Most common malformation of the midgut

Answer 14

Meckel’s diverticulum

Question 15

Rare, but the most common, symptomatic, vascular hepatic tumors of infancy and may cause nonimmune hydrops

Answer 15

Hemangioendothelioma

Question 16

The liver enlarges with ______ disease

Answer 16

Rh immune disease

Question 17

Mortality rate for partial situs Inversus is extremely high

With Aslpenia there is a __-__% chance
With polysplenia there is a __-__%chance

Answer 17

Aslpenia - 90-95%

Polysplenia - 80%

Question 18

Echogenic debris in the stomach may represent what?

Answer 18

Vernix
Protein
Intra-amniotic hemorrhage

Question 19

Small bowel is slightly ______ compared to the liver

Answer 19

hyperechoic

Question 20

_____ folds within the colon can help differentiate from small bowel

Answer 20

Haustral

Question 21

When are hepatic veins and fissures formed?

Answer 21

By the end of the 1st trimester

Question 22

Which lobe of the liver is largest in utero?

Answer 22

LEFT

Question 23

The gallbladder is seen sonographically after ____ weeks

Answer 23

20

Question 24

The pancreas is ____peritoneal and _____ to the SMA, Aorta, and IVC

Answer 24

retro peritoneal and anterior

Question 25

Fluid filled structure to the RIGHT of the portal-umbilical vein

Answer 25

The gallbladder

Question 26

If multiple calcifications are seen in the liver, ____ and ____ may be affected as well

Answer 26

Brain and Spleen

Question 27

Liver tumors are RARE {T/F}

Answer 27

TRUE

Question 28

Which situs inversus is more commonly associated with cardiac anomalies?

Answer 28

Asplenia situs inversus

Question 29

Sonolucent band identified near fetal anterior abdominal wall

Answer 29

Pseudoascites

Question 30

Will you see the falciform ligament with pseudoascites?

Answer 30

NO

Question 31

Calcifications within the gallbladder

Answer 31

Cholelithiasis {gallstones}

Question 32

Dilatation of the common bile duct

Answer 32

Choledochal cyst

Question 33

Causes for non visualization of the stomach {6}

Answer 33

1.Esophogeal atresia / tracheoesophageal fistula 
  {least common}
2.Diaphragmatic hernia
3.Facial cleft
4.Central nervous system
5.Other swallowing disorders
6.Olihydramnios for other causes

Question 34

Recognizing GI malformation in utero may prevent complications such as _____ , _____ , and ______.

Answer 34

dehydration, bowel necrosis, and respiratory difficulties

Question 35

a bowel obstruction results in _____ bowel dilation

Answer 35

proximal

Question 36

this develops when a portion of bowel grows and infarcts

Answer 36

Atresia

Question 37

Unusually echogenic bowel can typically be seen during the 2nd trimester; this may be due to …

Answer 37

decreased water content, alterations of meconium, or both

Question 38

congenital disorder in which there is an abnormal inner action of large intestine {MEGACOLON}

Answer 38

Hirschsprung’s disease

Question 39

The most common form of esophageal atresia is when it occurs with or without a fistula?

Answer 39

In conjunction WITH a fistula

Question 40

Theres a 30% incidence of duodenal atresia in ________

Answer 40

Downs syndrome {trisomy 21}

Question 41

Atresia or stenosis of the jejunum, ileum, or both and small bowel atresia are slightly more common than duodenal atresia {T/F}

Answer 41

TRUE

Question 42

Small bowel disorder marked by the presence of abnormally thick & sticky meconium in the distal ileum

Answer 42

Meconium ileus

Question 43

Meconium ileus is the earliest manifestation of _______.

Answer 43

cystic fibrosis

Question 44

In esophageal atresia without a fistula, will you seen the stomach?

Answer 44

NO

Question 45

Associated findings of Esophageal atresia

Answer 45

1. anorectal atresia {MOST COMMON}
   2.Vertebral defects {V}
   3.Anal atresia {A}
   4.Cardiac anomalies {C}
   5.Tracheoepsophageal fistula {TE}
   6.Renal anomalies {R}
2. Limb dysplasia {L}
   {VACTERL}

Question 46

Sonographic appearance with both duodenal atresia and esophageal atresia

Answer 46

POLYHYDRAMNIOS

Question 47

Atresia or stenosis of the jejunum, ileum, or both, and small bowel atresia are slightly more common than ______

Answer 47

duodenal atresia

Question 48

Complex disorder of bowel and genitourinary tract

Answer 48

anorectal atresia

Question 49

Anorectal atresia is associated with _____ or _____

Answer 49

VACTERL or caudal regression