Urogenital abnormalities and atresia of the gastrointestinal tract

Abstract

Introduction. The goal of the study was to investigate the frequency of urogenital congenital abnormalities among atresias of the digestive system and analyze fetal maldevelopment. The study also deals with gastrointestinal and urogenital embryology. Material and methods. This retrospektive study analyzed the clinical status of 55 new-borns admitted to the Pediatric Surgery Clinic in Novi Sad due to atresia of the gastrointestinal tract during 1995-2003. All atresias were classified at primordial gut levels (foregut, midgut and hindgut). The incidence of associated abnormalities, especially urogenital, was analyzed. Diagnostic procedures included standard methods: clinical investigation, ultrasound, native and contrast medium radiography, etc. Results. Results showed that urogenital anomalies were present in 21 (38.18%) newborns with gastrointestinal atresia. Foregut atresia was diagnosed in 14 newborns and it was associated with urogenital congenital anomalies in 9 (64.28%) newborns. Midgut atresias were found in 15 patients and in 4 (22.22%) they were associated with urogenital anomalies. Hindgut atresias were established in 23 and in 8 (34.78%) cases they were associated with urogenital anomalies. Discussion and conclusions. It was confirmed that foregut atresias are commonly accompanied by associated abnormalities. That is why the fourth gestational week is important when both gastroinestinal and urogenital systems are developed. When midgut differentiates into its own derivates, the frequency of congenital anomalies decreases for a short period, and then increases again during foregut development (seventh and eighth gestational weeks). There were no information on environmental teratogenic factors in maternal history. These abnormalities may be explained by complex urorectal development and separation of two systems. .