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SMALL STOMACH
(MIGROGASTRIA) |
Congenital microgastria is a rare anomaly in which
the normal rotation of the stomach does not occur and the greater and lesser
curvatures do not develop (1). A small tubular stomach with marked gastroesophageal reflux due to incompetence of the cardia develops.
It has been postulated to arise from arrested gastric development during the
first trimester.
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ULTRASOUND |
- Except in cases of severe oligohydramnios, the stomach should always be visualized by 14 weeks gestational age.
- Non-visualization of the
stomach or a small stomach may be a transient finding due to physiological
emptying of the stomach.
A repeat scan later that day or on another day is therefore necessary to confirm the diagnosis. - Stomach is persistently small, saccular or tubular in a midsagittal position (2).
- Amniotic fluid volume is normal.
Idiopathic polyhydramnios
– normal stomach
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Polyhydramnios- small
stomach (microgastria). Fetus had esophageal atresia with distal tracheo-esophageal
fistula |
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Severe
Microgastia – Almost
non-visualization of the stomach. Polyhydramnios. Esophageal atresia with no distal fistula was present post-natally. |
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ASSOCIATIONS (1,3-8) |
- Asplenia (spleen and stomach are both derived from the embryonic dorsal mesogastrium).
- Occasionally polysplenia (3).
- Cardiac malformations.
- Gastrointestinal malformations.
- Tracheo-esophageal fistula / Esophageal atresia.
- Duodenal atresia.
- Malrotation, Hirschsprung's disease and imperforate anus.
- Musculoskeletal malformations.
- VATER association (1).
- Radial, ulnar and thenar hypoplasia (9).
REFERENCES |
- Shackelford GD, McAlister WH, Brodeur AE et.al. Congenital microgastria. AJR 1973;118:72.
- Hoehner JC, Kimura K, Soper RT. Congenital microgastria. J Pediatr Surg 1994;29(12):1591-1593.
- Hill LM. Congenital microgastria: Absence of the fetal stomach and normal third trimester amniotic fluid volume. J Ultrasound Med 1994;13:894-896.
- Kessler H, Smullewicz J. Microgastria associated with agenesis of the spleen. Pediatr Radiol 1973;107:393-396.
- Aintablian A, Slim M, Antoun B. Congenital microgastria: case report and review of the literature. Pediatr Surg Int 1987;2:307-310.
- Gorman B, Shaw DG. Congenital microgastria. Br J Radiol 1984;57:260-262.
- Hochberger O, Swoboda W. Congenital microgastria: A follow-up observation over six years. Pediatr Radiol 1974;2:207-208.
- Bland E, Chisolm A. Congenital microgastria, a case report with a 26-year follow up. Pediatrics 1973;51:1037-1041.