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© 2004 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 23:1211-1215 • 0278-4297

Case Series

Using Color Doppler Sonography to Identify the Perivesical Umbilical Arteries

A Useful Method in the Prenatal Diagnosis of Omphalocele-Exstrophy-Imperforate Anus-Spinal Defects Complex

Joung-Liang Wu, MD, Kung-Hong Fang, MD, Guang-Perng Yeh, MD, Pan-Hsin Chou, MD and Charles Tsung-Che Hsieh, MD

Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan, Republic of China (J.-L.W., K.-H.F., G.-P.Y., P.-H.C., C.T.-C.H.); and Department of Obstetrics and Gynecology, Chung-Shan Medical University, Taichung, Taiwan, Republic of China (G.-P.Y.).

Address correspondence and reprint requests to Charles Tsung-Che Hsieh, MD, Department of Obstetrics and Gynecology, Changhua Christian Hospital, 135 Nanhsiao St, 500 Changhua, Taiwan, Republic of China. E-mail: 40129{at}cch.org.tw.

Objective. To describe the different prenatal sonographic findings in 3 cases of omphalocele-exstrophy-imperforate anus-spinal defects (OEIS) complex, or cloacal exstrophy. Methods. Three patients with OEIS complex were examined by sonography. In 2 (cases 2 and 3) of the 3 cases, color Doppler sonography was applied to the area of cord insertion and the abdominal mass to determine the origin of the abdominal mass. Results. Three cases of OEIS complex with different sonographic appearances are included in this series. An absent bladder without an abdominal mass but with bowel floating in the amniotic cavity was revealed in case 1; an absent bladder with a lower anterior abdominal mass was found in the second trimester in case 2; and a large cystlike mass located in the anterior abdominal wall was found in case 3. Color Doppler imaging showed that the abdominal mass originated from the urinary bladder in cases 2 and 3; therefore, OEIS complex was presumptively diagnosed antenatally in these cases. In all cases, OEIS complex was confirmed postnatally. Conclusions. Omphalocele-exstrophy-imperforate anus-spinal defects complex should be considered in patients with an absent bladder combined with either an anterior abdominal wall mass or defects. Special attention should be given to search for other combined anomalies. We suggest that color Doppler sonography for identifying the perivesical umbilical arteries is a very useful method in establishing of the diagnosis of OEIS complex.

Key Words: cloacal exstrophy • color Doppler sonography • omphalocele-exstrophy-imperforate anus-spinal defects complex • sonography

Abbreviations: OEIS, omphalocele-exstrophy-imperforate anus-spinal defects

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Copyright © 2004 by the American Institute of Ultrasound in Medicine.