title: Bladder outlet obstruction causes fetal enterolithiasis in anorectal malformation with rectourinary fistula.
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.
authors.affiliation: Department of Paediatric Surgery, University of Leipzig, 04317 Leipzig, Germany. udo.rolle@medizin.uni-leipzig.de
authors.forename: Udo
authors.initials: U
authors.lastname: Rolle
authors.forename: Renaldo
authors.initials: R
authors.lastname: Faber
authors.forename: Eva
authors.initials: E
authors.lastname: Robel-Tillig
authors.forename: Oliver
authors.initials: O
authors.lastname: Muensterer
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hirsch
authors.forename: Holger
authors.initials: H
authors.lastname: Till
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis* / Q000628:therapy; D001003:Anal Canal / Q000002:abnormalities*; D002114:Calcinosis / Q000175:diagnosis*; D003125:Colostomy; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008470:Meconium; D012003:Rectal Fistula / Q000175:diagnosis*; D012007:Rectum / Q000002:abnormalities*; D016216:Ultrasonography, Prenatal; D001748:Urinary Bladder Neck Obstruction / Q000175:diagnosis*; D014548:Urinary Fistula / Q000175:diagnosis*