Abstract

HEINEN, Fernando et al. Masas quísticas expansivas en tórax y abdomen en un feto: Tratamiento mininvasivo posnatal. Arch. argent. pediatr. [online]. 2005, vol.103, n.1, pp.67-71. ISSN 0325-0075.

Fetal thoracic masses may cause hydrops and intrauterine death or pulmonary hypoplasia and neonatal ventilatory failure. We present a male fetus with two cystic masses which were detected at the 26º week of gestation. The huge unilocular right thoracic cystic mass measured 6 x 6 cm and caused a severe displacement of both lungs and the mediastinum. The abdominal cystic mass in the right flank was 4 x 4 cm. in size and had no communication with the former. Other associated anomalies were ruled out through a fetal MRI. Weekly sonographic follow-up until term did not show hydrops fetalis. Threfore a multidisciplinary perinatal reception was arranged at term, with a cesarean section, to immediately solve the expected neonatal hypoxia. The thoracic cyst was decompressed under US guidance with a 10 French trocar, and 200cc of fluid were evacuated before both lungs could expand. After 48 hours of ventilatory support, the thoracic intestinal duplication was resected through videothoracoscopy using 3 mm instruments. After an uneventful recovery, the abdominal jejunal cystic duplication, which had then expanded up to 8 x 8 cms., was also resected, through a mini-invasive laparoscopically assisted procedure at 18 days of age. The baby was discharged home with full breast feeding at 24 days of age.

Keywords : Prenatal diagnosis; Intestinal duplication; Pulmonary hypoplasia.

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