1
|
Chelu SC, Kundnani NR, Nistor D, Chiriac VD, Brad GF, Cerbu S, Iancu MA, Borza C. Importance of Prenatal Diagnosis of Ileal Atresia in Gestational Diabetes Cases. Am J Case Rep 2024; 25:e942838. [PMID: 38584385 PMCID: PMC11009888 DOI: 10.12659/ajcr.942838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/25/2024] [Accepted: 02/16/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Maldevelopment of the fetal bowel can result in the rare condition of intestinal atresia, which results in congenital bowel obstruction. This report describes a case of prenatal diagnosis of fetal ileal atresia at 22 weeks' gestation. CASE REPORT Here, we present a 24-year old woman who was 22 weeks into her first pregnancy when she underwent routine fetal ultrasound. She was diagnosed with gestational diabetes mellitus. Her body mass index was normal and she had normal weight gain. The ultrasonographic examination performed revealed a hyperechoic bowel and a small dilatation of the bowel. The couple was counselled for possible intestinal atresia and its postnatal implications. At 33 weeks of gestation, polyhydramnios appeared, and the intestinal distension was much more pronounced, with hyperechoic debris in the intestinal lumen (succus-entericus). After birth, surgery was performed and we concluded the patient had type II atresia, which was surgically treated. CONCLUSIONS This report has highlighted the importance of antenatal ultrasound in detecting fetal abnormalities, and has shown that rare conditions such as intestinal atresia can be accurately diagnosed and successfully managed. Surgical correction, if implemented promptly after stabilizing the general condition, can have a relatively good prognosis. Coexisting fetal ileal atresia and gestational diabetes mellitus are rare occurrences, which can make each condition even more difficult to treat.
Collapse
Affiliation(s)
- Sorina Cristina Chelu
- Department of Functional Science, Discipline of Pathophysiology, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Center for Translational Research and Systems Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Discipline of Obstetrics and Gynecology, “Victor Babeş” University of Medicine and Pharmacy Timişoara, Timişoara, Romania
| | - Nilima Rajpal Kundnani
- Department of Cardiology – Internal Medicine and Ambulatory Care, Prevention and Cardiovascular Recovery, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Research Centre of Timişoara Institute of Cardiovascular Diseases, Timişoara, Romania
| | - Daciana Nistor
- Department of Functional Sciences, Physiology, Centre of Immuno-Physiology and Biotechnologies (CIFBIOTEH), “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Oncogen, Centre for Gene and Cellular Therapies in Cancer, Timişoara, Romania
| | - Veronica Daniela Chiriac
- Discipline of Obstetrics and Gynecology, “Victor Babeş” University of Medicine and Pharmacy Timişoara, Timişoara, Romania
| | - Giorgiana Flavia Brad
- Department XI of Pediatrics, 1 Pediatric Discipline, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, România
- 1 Pediatric Clinic, “Louis Ţurcanu” Children’s Clinical and Emergency Hospital,Timişoara, România
| | - Simona Cerbu
- Discipline of Radiology and Medical Imaging, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
| | - Mihaela Adela Iancu
- Department 5, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Claudia Borza
- Department of Functional Science, Discipline of Pathophysiology, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Center for Translational Research and Systems Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
- Centre of Cognitive Research in Pathological Neuro-Psychiatry NEUROPSY-COG, “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania
| |
Collapse
|
2
|
Abstract
Osteogenesis imperfecta (OI) is a genetic disease characterized by excessive bone fragility with fractures consecutive to minor trauma. Considering lack of standardization of therapy with pamidronate in children, it was our aim to present our experience over a period of 10 years regarding evolution and treatment in patients diagnosed with osteoporosis and OI. Nine patients diagnosed with OI were admitted to the First Pediatric Clinic, Timisoara. They were investigated (clinical, biomarkers of bone metabolism and imaging studies), and a quality-of-life questionnaire was used to evaluate the impact of OI. Treatment was performed with pamidronate 1 mg/kg/cycle, every 3 months. The patients were evaluated every 3 months. The most frequent was type III (three patients), and two patients were diagnosed with type II, while the other patients were diagnosed with other forms such as types IV, V, VI and VIII. The clinical expression was polymorphic, and the number of fractures was variable. Bone pain ameliorated just after the first cycle of pamidronate, while the activity and mobility increased quickly. Osteodensitometry in children over 12 years showed a decreased bone mineral density (BMD) with a significant improvement after treatment. The values of the bone alkaline phosphatase and osteocalcin changed after the antiresorptive treatment, and the quality of life of the children and their family improved. Treatment with pamidronate is beneficial for the patient, family and society, increases mobility and bone density, improves quality of life and reduces family dependence in children with OI.
Collapse
Affiliation(s)
| | | | | | - Ioana Mozos
- Department of Functional Sciences.,Center for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | | |
Collapse
|