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The esophageal ‘pouch sign’: a benign transient finding
Author(s) -
Solt Ido,
Rotmensch Siegfried,
Bronshtein Moshe
Publication year - 2010
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2568
Subject(s) - medicine , pouch , pathognomonic , polyhydramnios , fetus , gestation , atresia , stomach , pregnancy , anatomy , obstetrics , biology , genetics , disease
Objective Sonographic finding of an esophageal pouch is considered pathognomonic for fetal esophageal atresia (EA). We investigated the clinical significance of this finding. Methods Longitudinal sonographic follow‐up in pregnancy and neonatal diagnostic work‐up was performed in six fetuses with an esophageal neck pouch referred for polyhydramnios and a small or absent stomach. Fetal swallowing and cyclic distension of the pouch were observed for at least 30 min, and follow‐up examinations were conducted at 2 to 3 weeks intervals. Results First visualization of the pouch occurred between 18 and 29 weeks of gestation. All pouches were located above the fetal clavicle. No additional anomalies were detected on detailed anatomic survey. Five fetuses had normal karyotypes. At 21 to 33 weeks of gestation, polyhydramnios had resolved, and the stomach was found to be normal in size and shape in all cases. The neonatal work‐up ruled out EA in all cases. Conclusion The fetal esophageal pouch sign occurs in structurally normal fetuses and should not be considered pathognomonic for EA or serve as the grounds for pregnancy termination. Copyright © 2010 John Wiley & Sons, Ltd.