Fetal stomach and gallbladder in contact with the bladder wall is a common ultrasound sign of stomach-down left congenital diaphragmatic hernia.
OBJECTIVE
The aim of this study was to identify sonographic (US) findings that can assist in prenatal diagnosis of stomach-down left congenital diaphragmatic hernia (CDH), specifically related to positioning of the abdominal contents including the stomach, bladder, and gallbladder.


METHODS
All US examinations with a postnatally confirmed diagnosis of stomach-down left CDH over a 13-year period were retrospectively reviewed for abnormal position of the abdominal contents, including whether the fetal stomach was in contact with the urinary bladder. Normal fetuses that underwent comprehensive US surveys were similarly evaluated for comparison in a 2:1 ratio.


RESULTS
Twenty-two fetuses with stomach-down left CDH were identified in a cohort of 278 fetuses with left CDH. In 15/22 (68.2%) cases of stomach-down left CDH, the bladder and stomach walls were in contact. Contact of the fetal gallbladder with the fetal bladder wall was also observed and was present even more commonly (17/22 cases [77.3%]). There was no case of either the stomach or gallbladder in contact with the bladder wall in the normal fetal cohort (n = 44).


CONCLUSIONS
Recognition of the fetal stomach and/or gallbladder in contact with the bladder wall can help in the detection of stomach-down left CDH. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:8-13, 2017.
Department of Radiology and Biomedical Imaging, University of California San Francisco, L374, 505 Parnassus Avenue, San Francisco, CA, 94143-0628.
Tara A
TA
Morgan
Department of Diagnostic Radiology, Oregon Health & Science University, Portland, OR.
Amaya
A
Basta
Department of Radiology and Biomedical Imaging, University of California San Francisco, L374, 505 Parnassus Avenue, San Francisco, CA, 94143-0628.
Roy A
RA
Filly
D016022:Case-Control Studies; D005260:Female; D005704:Gallbladder / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000196:embryology; D065630:Hernias, Diaphragmatic, Congenital / Q000000981:diagnostic imaging* / Q000196:embryology; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D013270:Stomach / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000196:embryology; D016216:Ultrasonography, Prenatal; D001743:Urinary Bladder / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000196:embryology
bladder; congenital diaphragmatic hernia; gallbladder; prenatal diagnosis; stomach