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Paradoxical Movement of Abdominal Contents
Author(s) -
Sista Akhilesh K.,
Filly Roy A.
Publication year - 2007
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2007.26.11.1617
Subject(s) - medicine , congenital diaphragmatic hernia , fetus , mediastinal shift , in utero , diaphragmatic breathing , radiology , fetal movement , diaphragmatic hernia , hernia , pathology , pregnancy , lung , biology , genetics , alternative medicine
Objectives A congenital diaphragmatic hernia (CDH) is the most common intrathoracic extracardiac congenital anomaly, and it is associated with high mortality and other fetal abnormalities. Early diagnosis is essential for delivery planning and possible intervention. However, the in utero diagnosis of CDHs by sonography can be challenging. We report the utility of paradoxical movement of the intra‐abdominal contents in identifying CDHs. Methods Two fetal cases were identified: 1 referred with a suspected CDH and the other with a mediastinal shift and a suspected congenital cystic adenomatoid malformation (CCAM). Real‐time sonography was performed in both fetuses with attention on movement of the intra‐abdominal contents during fetal breathing, particularly during inspiration. Results Real‐time sonography in both fetuses showed paradoxical movement of the abdominal contents during fetal inspiration. In the case with the presumptive diagnosis of a CCAM, the paradoxical motion was essential in changing the diagnosis from a CCAM to a CDH. Conclusions Paradoxical movement of the abdominal contents can be used in addition to the traditional sonographic signs in diagnosing CDHs.