Prenatal Ultrasound Progression and Postnatal Retrospective Analysis of a Case of Small Intestinal Atresia with Volvulus

Background and Clinical Significance: Fetal jejunoileal atresia is a congenital anomaly of the lower digestive tract. Subsequent small intestinal volvulus, which may occur secondary to intestinal malrotation or atresia, represents a common cause of neonatal intestinal obstruction. The synthesis of intestinal atresia and volvulus is a dynamic, progressive process with distinct imaging features at each stage. Serial fetal ultrasound can detect abnormalities, and imaging changes may evolve from the initial onset of atresia to the development of volvulus. Case Presentation: We report the clinical data of a neonate diagnosed postnatally with small intestinal atresia complicated by volvulus, analyzed from a prenatal ultrasound perspective. The data include prenatal ultrasound findings, magnetic resonance imaging (MRI) results, postnatal ultrasound and computed tomography (CT) findings, intraoperative observations, pathological results, and clinical outcomes, followed by a retrospective analysis and discussion. In this case of small intestinal atresia with volvulus, prenatal ultrasound at 31 weeks of gestation revealed an enlarged stomach, proximal intestinal dilation, and collapse of the distal intestine (based on retrospective image review). At 35 weeks of gestation, a cystic mass resembling a “coffee bean sign” was detected in the fetal abdominal cavity (identified on retrospective image review), accompanied by polyhydramnios. Cesarean section was performed at 37 weeks, and the neonate underwent surgery on the second postnatal day. Intraoperative findings confirmed small intestinal atresia (Type IIIa) complicated by volvulus. The neonate recovered well postoperatively, and follow-up assessments indicated normal. Conclusions: Based on the retrospective analysis of this case, we propose that serial prenatal ultrasound and recognition of progressive imaging changes from intestinal atresia to volvulus carry important clinical significance. Multidisciplinary prenatal consultation plays a crucial role in formulating feasible postpartum treatment plans, thereby enhancing clinicians’ ability to manage such conditions effectively.