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英文誌(2004-)

Journal of Medical Ultrasonics

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1989 - Vol.16

Vol.16 No.01

Case Report(症例報告)

(0092 - 0097)

先天性消化管閉鎖が疑われた腟腫大の2例

The Relationship between Echo-free Spaces in Fetal Abdomen in Utero and Enlargement of Vagina: Report of Two Cases

細田 修司1, 岩崎 昭宏2, 草西 洋1, 水谷 不二夫1

Shuji HOSODA1, Akihiro IWASAKI2, Hiroshi KUSANISHI1, Fujio MIZUNOYA1

1明石市立市民病院産婦人科, 2明石市立市民病院臨床検査科

1Department of Obstetrics and Gynecology, Akashi Municipal Hospital, 2Hospital Laboratories, Akashi Municipal Hospital

キーワード : Enlargement of the vagina, Atresia ani, Vaginography, Congenital atresia of the intestine

A 31-year-old woman, gravida 2, para 1, was admitted at 38 weeks' gestation for the management of preeclampsia. Ultrasonography revealed evidences of fetal intestinal atresia, especially in the rectal portion, as several echo-free spaces in the abdomen. 3 days after admission, she had a normal spontaneous delivery of a 1,870 gm female infant with Apgar scores of 9 and 10 at 1 and 5 minutes, respectively. The echo-free space in infant abdomen was not detected by ultrasonography, but vaginography revealed evidence of enlargement of the infant's vagina. A 33-year-old woman, gravida 2, para 1, was uneventful until 36 weeks' gestation, when ultrasonography revealed evidence of fetal rectal atresia. She had a normal spontaneous delivery of a 3,450 gm female infant with Apgar scores of 10 and 10 at 1 and 5 minutes at 40 weeks' gestation. The echo-free space in the infant abdomen was detected by ultrasonography, and vaginography revealed evidence of enlargement of the infant's vagina. Our two cases may be in the category of genital pseudotumor. D.R. Kirks says that a normal newborn female may have genital hypertrophy producing an interlabial or cul-de-sac mass due to maternal estrogen effect. Several echo-free spaces in the fetal abdomen in utero may have some relation to the enlargement of fetal vagina. Careful clinical evaluation as well as ultrasonography or vaginography permits correct diagnosis of this genital pseudotumor which will recede in the weeks following birth.