title: Alveolar capillary dysplasia associated with duodenal atresia: ultrasonographic findings of enlarged, highly echogenic lungs and gastric dilatation in a third-trimester fetus.
abstract: We report a case of alveolar capillary dysplasia, wherein duodenal atresia was diagnosed during the third trimester. A 36-year-old mother was referred to our hospital for polyhydramnios at 31 weeks' gestation. Duodenal atresia was suspected from the ultrasonographic findings, which showed gastric dilation. Other findings noted were enlarged, highly echogenic lungs, a spherical heart and an increased lung-thorax transverse area ratio. A male infant was born at 37 weeks' gestation. The findings of serial radiography of the infant's upper gastrointestinal tract were compatible with the diagnosis of duodenal atresia; however, he developed persistent pulmonary hypertension of the newborn eight hours after birth and died at five days of age. The autopsy revealed alveolar capillary dysplasia and duodenal obstruction. We propose that the detection of duodenal atresia should prompt the physician to conduct a thorough ultrasonographic examination to rule out associated anomalies, such as alveolar capillary dysplasia, which can be detected by the presence of highly echogenic lungs.
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan. manobata@md.tsukuba.ac.jp
authors.forename: Mana
authors.initials: M
authors.lastname: Obata-Yasuoka
authors.forename: Hiromi
authors.initials: H
authors.lastname: Hamada
authors.forename: Rena
authors.initials: R
authors.lastname: Ohara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakao
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Miyazono
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging*; D000328:Adult; D004380:Duodenal Obstruction / Q000000981:diagnostic imaging*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D013271:Gastric Dilatation / Q000000981:diagnostic imaging*; D006801:Humans; D007409:Intestinal Atresia; D050498:Live Birth; D008168:Lung / Q000000981:diagnostic imaging* / Q000196:embryology / Q000473:pathology; D010547:Persistent Fetal Circulation Syndrome / Q000000981:diagnostic imaging*; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011650:Pulmonary Alveoli / Q000002:abnormalities / Q000000981:diagnostic imaging; D016216:Ultrasonography, Prenatal