Congenital microvillous inclusion disease presenting as antenatal bowel obstruction.
Prenatal ultrasound has led to confidence in the antenatal diagnosis of intestinal obstruction allowing counseling and birth planning. We describe a male infant of a diabetic mother who had an antenatal diagnosis of distal bowel obstruction. This baby was subsequently found not to have bowel obstruction, but a congenital enteropathy - microvillous inclusion disease. The antenatal scans had demonstrated polyhydramnios as well as multiple fluid-filled dilated loops of bowel in the fetal abdomen. To our knowledge, similar prenatal ultrasound findings have not been previously described in this condition. The baby was delivered in a pediatric surgical center and postnatally there was no evidence of bowel obstruction either clinically or on abdominal X-ray. This baby initially fed well, but became collapsed and acidotic on his third day, having lost 26% of his birth weight due to excessive stool loss. The diagnosis of microvillous inclusion disease was made by electron microscopy of a small bowel biopsy. Congenital microvillous inclusion disease is a very rare inherited enteropathy with high mortality and morbidity. This condition, and other enteropathies, should be considered in cases in which antenatally diagnosed bowel obstruction is not confirmed after birth.
Kennea
N
N
Department of Child Health, London, UK. n.kennea@ic.ac.uk
Norbury
R
R
Anderson
G
G
Tekay
A
A
D000328:Adult; D003968:Diarrhea, Infantile / Q000209:etiology*; D004108:Dilatation, Pathologic; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000209:etiology*; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging*; D007422:Intestines / Q000166:cytology / Q000473:pathology; D008297:Male; D008871:Microvilli; D011247:Pregnancy; D016216:Ultrasonography, Prenatal