Abnormal abdominal situs: what and how should we look for?

BACKGROUND

Prenatal management of abnormal abdominal situs is challenging since prognosis is highly variable depending on the associated malformations.

METHODS

The authors report on two cases of ambiguous abdominal situs. Prenatal management included specialized ultrasound examination of fetal anatomy and heart, amniocentesis for determination of the fetal karyotype and fetal abdominal MR.

RESULTS

In both cases, abnormal situs was associated with other abdominal anomalies such as azygous continuation, biliary atresia, bowel obstruction and polysplenia. Fetal MR was a useful additional tool in the assessment of fetal abdominal anatomy in both cases.

CONCLUSIONS

On the basis of these reports, the literature is reviewed and a prenatal management scheme is proposed.