Prenatal ultrasound diagnosis of fetal congenital pyriform sinus fistula: a case report
宋宴鹏 1李明 1张宇航 2高雪莲
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作者信息
1. 青岛市胶州中心医院特检科，青岛 266300
2. 太仓市第一人民医院超声科，苏州 215400
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摘要
本文报道1例产前超声诊断的胎儿先天性梨状窝瘘病例。孕妇孕17周+2产前常规超声检查发现胎儿左侧颈部椭圆形囊性包块，孕23周行产前系统超声筛查发现胎儿左侧颈部囊性包块，在颈部冠状位切面探及囊性包块上端与喉部有一细窄窦道形成，考虑先天性梨状窝瘘。生后21 d，患儿左侧颈部包块明显隆起，吃奶时出现呛咳及呼吸时伴有喘鸣音。生后21 d超声检查及生后25 d CT检查均发现左侧颈部囊性包块及囊内有气体。生后26 d全身麻醉下行颈部开放性囊肿切除术+高位瘘管缝扎及瘘管切除术，术中诊断为先天性梨状窝瘘。患儿术后愈合良好，随访至3月龄未出现并发症。 This article reported a case of fetal congenital pyriform sinus fistula (CPSF) diagnosed by prenatal ultrasound. An oval cystic mass in the left side of the fetal neck was detected during routine prenatal ultrasonography at 17+2 weeks of gestation, which was also found in the systemic ultrasound screening at 23 weeks. Besides, a narrow fistula between the cyst and pharynx was observed in the coronal view of the neck, raising the suspicion of CPSF. On day 21 after birth, the cystic mass bulged out of the neck and the neonate started choking and coughing during feeding alongside wheezing respiration. Ultrasound examination showed a strong gas echo in the cystic mass, which was also confirmed by CT scan on day 25. On day 26, cystectomy, ligation of high fistula, and fistulectomy were performed, and the diagnosis of CPSF was confirmed. The baby recovered after the operation and was healthy during follow-up till three months.
Abstract
This article reported a case of fetal congenital pyriform sinus fistula (CPSF) diagnosed by prenatal ultrasound. An oval cystic mass in the left side of the fetal neck was detected during routine prenatal ultrasonography at 17+2 weeks of gestation, which was also found in the systemic ultrasound screening at 23 weeks. Besides, a narrow fistula between the cyst and pharynx was observed in the coronal view of the neck, raising the suspicion of CPSF. On day 21 after birth, the cystic mass bulged out of the neck and the neonate started choking and coughing during feeding alongside wheezing respiration. Ultrasound examination showed a strong gas echo in the cystic mass, which was also confirmed by CT scan on day 25. On day 26, cystectomy, ligation of high fistula, and fistulectomy were performed, and the diagnosis of CPSF was confirmed. The baby recovered after the operation and was healthy during follow-up till three months.
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