A 26-year-old pregnant woman with 27 weeks of amenorrhea had persistent abdominal pain and vomiting. Her surgical history was significant for Roux-en-Y gastric bypass 4 years earlier. Abdominal examination showed left-side tenderness. Ultrasound study showed no obstetric abnormality but could not identify the cause of the pain. Abdominal magnetic resonance imaging (Figures 1 and 2) showed a target sign centered by mesenteric vessels, diagnostic of jejunojejunal intussusception. The patient underwent exploratory laparotomy (Figure 3) that confirmed jejunojejunal intussusception that was managed successfully by simple manual reduction. After the surgery, there were neither sign of symptoms recurrence nor obstetric complication. Figure 2Axial true fast imaging with steady state precession magnetic resonance imaging Show full caption Axial true fast imaging with steady state precession magnetic resonance imaging (TrueFISP; Siemens Healthcare GmbH, Erlangen, Germany) shows mesentere (arrowheads) entering into the jejunum (star). Entry point in marked by a curved arrow. Moliere. The case for MRI in bowel obstruction during pregnancy. Am J Obstet Gynecol 2019. View Large Image Figure Viewer Download Hi-res image Figure 3Intraoperative view of jejunojejunal intussusception Show full caption Intraoperative view of jejunojejunal intussusception where nondilated jejunal intussuscipiens and the mesentere (arrowheads) enter the intussusceptum (curved arrow) with upstream jejunal occlusion (star). Moliere. The case for MRI in bowel obstruction during pregnancy. Am J Obstet Gynecol 2019. View Large Image Figure Viewer Download Hi-res image Axial true fast imaging with steady state precession magnetic resonance imaging (TrueFISP; Siemens Healthcare GmbH, Erlangen, Germany) shows mesentere (arrowheads) entering into the jejunum (star). Entry point in marked by a curved arrow. Moliere. The case for MRI in bowel obstruction during pregnancy. Am J Obstet Gynecol 2019. Intraoperative view of jejunojejunal intussusception where nondilated jejunal intussuscipiens and the mesentere (arrowheads) enter the intussusceptum (curved arrow) with upstream jejunal occlusion (star). Moliere. The case for MRI in bowel obstruction during pregnancy. Am J Obstet Gynecol 2019.

Prenatal diagnosis of an allantoic cyst with a patent urachus is rare. A urological etiology can sometimes be associated with it. We report 4 cases of allantoic cyst with a patent urachus and reviewed the literature to investigate for any etiology using the keywords “allantoic cyst” and “patent urachus”. Diagnosis of an allantoic cyst with a patent urachus was established during the first or second trimester of pregnancy. In two cases, rupture of prenatal cysts occurred and in one case, we described a prenatal vesicourethral abnormality. Surgery was performed with good results and no complications. A literature review collected 12 studies (15 fetuses) with a sex ratio of 3 boys/1 girl. The cysts ruptured in 2/3 of the cases, and in half of the cases, urinary abnormalities were found before birth (enlarged bladder, bladder prolapse). At birth, one boy had posterior urethral valve (PUV) and 4 boys had a bladder prolapse. The postoperative course was uneventful. We present our series with one case showing the etiology of a patent urachus during prenatal life. Cystoscopy seems to be valuable in the post-natal diagnosis. In the literature, we found one case of PUV. Surgery was performed with good results and no complications.