-
Hypoechoic linear structure ( Dome shaped) between lungs and abdomen
Diaphragm
-
Homogeneous hyper/isoechoic; not inflated with air
Lungs
-
4ch, 1/3 of chest, RV anterior chamber
Heart
-
One or both lungs decreased development (may be lethal)
Pulmonary hypoplasia
-
Causes of pulmonary hypoplasia
- Restricted chest cavity (skeletal dysplasia)
- Oligohydramnios with PROM and GU
- Chest masses (compression)
- Pleural effusion
-
What predicts hypoplasia with rib dysplasia?
Thoracic circumference
-
CCAM
Congenital cystic adenomatoid malformation
-
Benign hamartomatous lung tumor by abnormal proliferation of bronchioles; communicates with tracheobronchial tree
- CCAM:
- Unilateral
- Large causes mediastinal shift
-
CCAM is associate with
- Polyhydramnios
- Hydrops
- Hypoplasia
- Heart failure
-
"Macro cystic"
Variable size and shaped cysts >2cm ( single or multiple)
- Type 1 CCAM
- DDx: bronchogenic cysts
-
"Macro Micro"
Large echogenic lung with <2cm cysts (mass like)
-
"Micro cystic"
Large echogenic lung < 0.5cm cysts
*associated with hydrops
- Type 3 CCAM
- DDx: sequestration
-
Mass of pulmonary parenchyma separated from normal lung; does not communicate
*receives blood supply from systemic circulation
Echogenic mass, wedge shaped (associated with hydrops and Polyhydramnios )
- Pulmonary sequestration
- DDx: CCAM 2
-
Cystic structure lined by epithelium lung
Associated with other foregut anomalies
Uni/Multilocular cyst, mediastinal shift
- Bronchogenic cyst
- DDx: CCAM 1, pleural effusion
-
Portion of abdominal contents protrude into chest cavity ( intestines, stomach, liver)
* mediastinal shift
Congenital diaphragmatic hernia (CDH)
-
Posterolateral defect (commonly lt side)
Heart deviated to right
Foramen of bochdalek (CDH)
-
Partial or complete absence of central diaphragm behind sternum
Foramen of Morgagni (CDH)
-
CDH associated with
- Pulmonary hypoplasia
- Anencephaly (CNS defects)
- Trisomy 18 & 21
-
Lack if muscle causing abdominal contents to rise up to chest
- Eventration of diaphragm
- Can cause hypoplasia
-
Secondary pleural effusion associated with
?
-
Echogenic bilaterally enlarge lungs
Flattened diaphragm
Ascites, Polyhydramnios, fluid filled trachea
Tracheal atresia
-
Anterior chest wall fusion defect (heart outside cavity)
Ectopia cordis
-
Absent sternum
Anterior diaphragm defect
Pericardial defect
Ectopia cordis
Omphalocele
Pentalogy of Cantrell
-
Absent segment of esophagus
Small or absent stomach, Polyhydramnios
- Esophageal atresia (TE fistula)
- Associated with:
- VACTERL, trisomies, heart defects
-
Most common bowel obstruction
"Double bubble sign"
- Duodenal atresia and associated with:
- Cardiovascular anomalies
- Trisomy 21
- Other bowel anomalies
- Polyhydramnios
-
Dilated small bowel will?
Peristalsis
-
Colon should be less than? Small bowel should be less than?
18;12mm
-
Obstruction of small bowel by meconium due to cystic fibrosis
Appears as echogenic bowel
Meconium ileus
-
Bowel obstruction leading to perforation which leads to?
- Meconium peritonitis
- Bright echogenic mass
- Polyhydramnios
-
This is associated with cystic fibrosis, chromosomal abnormal, TORCH, meconium peritonitis
Echogenic bowel
-
Dilation of umbilical vein after entering abdomen
Umbilical vein varix
-
Right umbilical vein travels along abdomen and turns towards stomach instead of away
Persistent right umbilical vein
-
Hepatic calcifications caused by:
- TORCH
- Emboli
- Ishemic damage with necrosis
-
Midline defect of anterior abdominal wall with the umbilicus
- Omohalocele (bowel or liver organs)
- Covered by membrane
-
Small omphaloceles containing bowel are at risk for?
Chromosomal abnormalities
-
Large omphaloceles are associated with?
- Beckwith Wiedemann
- Petalogy of Cantrell
- Trisomy 18
- Ascites
-
Defect in abdominal wall to right of cord insertion ( bowel loops float freely)
Gastroschisis
-
Abdominal organs lie in sac outside cavity, covered by amnion, directly attached to placenta
Body stalk anomaly
-
Failure of closure of bladder, lower urinary tract, symphysis, rectus muscles, skin
- Bladder exstrophy
- Absent bladder with soft tissue anterior mass
- Malformation of genetalia
-
Bladder exstrophy
Omphaloceles
Imperforate anus
Spina Bifida
Coacal exstrophy
-
Omphalocele
Macroglossia (large tongue)
Viseromegaly (large organs)
Beckwith- Wiedemann syndrome
-
Ureteral buds (wolffian) become:
- Ureters
- Renal pelvis
- Calyces
- Collecting tubules
-
Urine production begins at?
11 weeks
-
Caudal end of cloacal forms urethera and bladder neck, allantois forms rest of?
Bladder embryology
-
Male genetalia formed when testosterone is present at
8-10weeks
-
Absent kidneys
Absent bladder
Oligohydramnios
- Bilateral renal agenesis
- (Can occur unilateral too but may be mistaken in utero)
-
Bilateral renal agenesis
Pulmonary hypoplasia
Abnormal hand and feet
Facial anomalies
Potters syndrome
-
Concequence of severe Oligohydramnios
Potters sequence
-
Distension if renal pelvis (>5mm) and calyces with urine due to obstruction, reflux, or ureterocele
Hydronephrosis
-
Dilated renal pelvis only
Grade 1 hydronephrosis
-
Dilated renal pelvis and calyces visible
Grade 2 hydronephrosis
-
Dilated renal pelvis and calyces
Grade 3 hydroneohrosis
-
Grade 3 and parenchymal thinning
Grade 4 hydronephrosis
-
Membranes that occur in the prostatic urethra that obstructs flow of urine
Large distended bladder "keyhole"
Oligohydramnios
Hydronephrosis
- Posterior urethral valves obstruction (PUV)
- Precursor to Prune Belly syndrome
-
Obstruction at Junction of renal pelvis and ureter
Usually unilateral
- Ureteropelvic junction (UPJ) obstruction
- *Most common cause of neonate obstruction
-
Usually due to duplicated renal collecting system (upper pole obstructs)
Associated with uretrocele
Ureterovesticular junction (UVJ) obstruction
-
Cystic dilation of Intravesticular portion of ureter
Ureterocele
-
ARPKD(infantile polycystic kidney disease)
- Defect of collecting duct (cortex)
- Bilateral
- Enlarged echogenic kidney
- Oligohydramnios
- Absent bladder
-
IPKD is associated with
- Meckel-Gruber syndrome (IPKD, polydactyl, encephalocele)
- Robert's syndrome
- Trisomy 13
-
Multiple lesions do not communicate with collecting system
Unilateral
Loss of reniform shape
MCDK
-
Deficiency in abdominal wall muscles
Undescended testes
Large bladder
Urinary tract obstruction
Oligohydramnios
Associate with pulmonary hypoplasia
- Prune belly syndrome
- "Eagle Barrett syndrome"
-
Solid mass in renal fossa
Unilateral
- Nephroblastoma
- "Wilms tumor"
-
Benign
Large solid mass arising from kidney
- Mesoblastic nephroma
- *Most common renal tumor in utero
-
Unilateral
Complex mass near upper pole of kidney; calcifications
- Neroblastoma "adrenoblastoma"
- *Most common abdominal tumor in newborns
-
Fluid in scrotum
Hydroceles
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