Article Text
Summary
Isolated fetal ascites was diagnosed at 20 weeks in a primiparous woman with no significant medical history. Progressive fetal ascites worsened after 28 weeks and resulted in fetal hydroceles. Delivery was by caesarian section at 33 weeks, preceded by reduction of fetal ascites under ultrasound guidance. Following delivery, the baby required further reduction of abdominal fluid and endotracheal intubation to provide respiratory support. An extensive set of investigations, including metabolic and genetic screening, was performed; all results were negative. On day two of life, the baby developed bilious aspirates and an abdominal radiograph suggested intestinal obstruction. At laparotomy, an ‘apple peel’ jejunal atresia, abnormal mesentery with precarious blood supply and a proximal perforation were identified and the perforation ‘sewn over’. The postoperative course was unremarkable, with Monogen feeds tolerated three weeks later. The baby continued to thrive at one year, tolerating increasing amount of long-chain fatty acids in diet.
- materno-fetal medicine
- paediatric surgery
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Footnotes
Contributors All authors took active part in the management of the case. OO collected the data and wrote the initial draft. The initial draft was reviewed by NE in terms of literature review and general structure, by BJ with regards to the surgical management and by ER from the follow-up and nutritional management point of view. All authors approve the final version.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.