GASTRIC PSEUDOMASS

• Homogeneous well defined echogenic material in the stomach (1).
• Gastric content of the fetus consists of swallowed amniotic fluid containing cells from the skin, urinary epithelium, and umbilical cord, which have undergone digestion (2). Lumps of vernix in the third trimester contribute to the echogenicity of the mass.

Vernix in stomach – clumped is a pseudomass in the upper images and loose in the lower images

• Has been reported following second trimester amniocentesis (3) and other causes of intra-amniotic bleeding (subchorionic hemorrhage and placental abruption). Assessment for indirect signs of intra-amniotic bleeding is therefore essential (hyperechoic bowel, particles in the amniotic fluid and the placenta).
• More commonly seen in the fetus with bowel obstruction.
• Incidence = 0.35-0.96% (1,3).

ULTRASOUND

• Mass-like conglomeration of echoes.
• Floating echoes.
• Fluid-fluid level.

Video clip of Gastric Pseudotumor

Gastric Pseudomass. Subchorionic hemorrhage with rupture into the amniotic cavity. Gastric pseudomass due to ingested blood.

REFERENCES

1. Fakhry J, Shapiro LR, Schechter A et.al. Fetal gastric pseudomasses. J Ultrasound Med 1987;6:177-180.
2. Tyden O, Bergstrom S, Nilsson BA. Origin of amniotic fluid cells in mid-trimester pregnancies. Br J Obstet Gynecol 1981;88:278.
3. Daly-Jones E, Sepulveda W, Hollingsworth J et.al. Fetal intraluminal gastric masses after second trimester amniocentesis. J Ultrasound Med 1994;13:963-966.