PDF(Pubmed)
Abstract：
Lower urinary tract obstruction (LUTO) is a rare fetal condition associated with significant perinatal morbidity and mortality. Herein, we report a neonatal case of LUTO with anal atresia complicated by anhydramnios and pulmonary hypoplasia. After treatment for severe postnatal respiratory distress, the neonate underwent vesicostomy and colostomy. Postoperatively, respiratory status and renal function improved. This case highlights a unique feature where a large rectovesical fistula channeled fetal urine into the colon, which minimized obstructive damage to the urinary tract and preserved renal morphology. Fetal colonic dilatation and numerous enteroliths indicate urine influx into the intestinal tract. Our case suggests the importance of recognizing such exceptions in complete LUTO to predict postnatal outcomes diagnosed in utero.
摘要：
下尿路梗阻（LUTO）是一种罕见的胎儿疾病，与围产期的发病率和死亡率有关。在这里，我们报告一例新生儿LUTO伴肛门闭锁并发羊水过多和肺发育不全。治疗严重的产后呼吸窘迫后，新生儿接受了膀胱造口术和结肠造口术。术后,呼吸状态和肾功能改善。此病例突出了一个独特的特征，即一个大的直肠膀胱瘘将胎儿尿液引导到结肠中，最大程度地减少了对泌尿道的阻塞性损害并保留了肾脏形态。胎儿结肠扩张和大量肠结石表明尿液流入肠道。我们的案例表明，在完整的LUTO中识别此类例外对于预测子宫内诊断的产后结局的重要性。
