Dilated and echogenic fetal bowel and postnatal outcomes: a surgical perspective. Case series and literature review.

INTRODUCTION: Foetal dilated or echogenic bowel have been described as markers for a variety of conditions including bowel obstruction, chromosomal and infectious disorders and cystic fibrosis. We aim to describe possible surgical interventions and outcomes.

METHODS: A 5-year review was performed of the clinical course of infants with antenatally diagnosed isolated echogenic bowel and/or dilated bowel or intraabdominal echogenic foci presenting at Princess Margaret Hospital for Children, Perth, Western Australia.

RESULTS: Abnormal antenatal findings were present in 35 foetuses. Twelve babies underwent surgery for intestinal atresia, meconium ileus and duplication cysts. Postoperative courses and outcomes were good.

CONCLUSIONS: Echogenic bowel on antenatal ultrasound is a non-specific marker for a variety of disorders. Although associated with higher rates of foetal loss, the majority of neonates are normal at delivery. Bowel dilatation with or without echogenicity is often predictive of bowel obstruction requiring surgery. Surgical outcomes are, however, very good. Echogenic foci elsewhere in the abdomen have little postnatal significance.