Antenatal sonographic features of aneurysmal dilatation of a vitelline vein

被引:20
|
作者
Benoist, G.
Gauthier, F.
Belloy, F.
Laloum, D.
Herlicoviez, M.
Dreyfus, M.
机构
[1] CHU Caen, Dept Obstet Gynecol, Serv Gynecol Obstet & Med Reprod, F-14000 Caen, France
[2] CHU Caen, Serv Radiol Pediat, F-14000 Caen, France
[3] CHU Caen, Serv Neonatol, F-14000 Caen, France
[4] Hop Kremlin Bicetre, Serv Chirurg Pediat, Paris, France
关键词
cavernous; congenital; hemangioma; prenatal diagnosis; umbilical vein; venous anomalies; vitelline vein;
D O I
10.1002/uog.3993
中图分类号
O42 [声学];
学科分类号
070206 ; 082403 ;
摘要
We report a case of aneurysmal dilatation of a vitelline vein observed antenatally. Intra-abdominal vascular dilatation was diagnosed on ultrasound examination at 24 weeks' gestation. The relationship with the umbilicus and portal vein suggested the diagnosis of umbilical vein varix. Fetal tolerance remained excellent in spite of a gradual increase in the size of the dilated vein. Postnatal ultrasound examination revealed thrombosis of the aneurysm with gradual extension to the portal vein and the onset of serious coagulation problems. Operative findings on postnatal day 9 included the absence of intra-abdominal umbilical vein, and the presence of an abnormal, dilated and thrombosed vein connecting the umbilicus to the portal vein and following the trajectory of the right vitelline vein. Corrective surgery was attempted by resection of the aneurysm and portal thrombectomy, but this did not prevent the development of portal obstruction syndrome with cavernous hemangioma. This anomaly, in which the fetal venous return uses the vitelline vein in the absence of the umbilical vein, does not appear to have been described before. The mechanism in question could be anastomosis between the right vitelline vein and umbilical vein. Antenatal diagnosis should enable early surgical management before the formation of a portal thrombosis. Copyright (C) 2007 ISUOG. Published by John Wiley & Sons, Ltd.
引用
收藏
页码:708 / 711
页数:4
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