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Pregnancy Bliss | Reproductive Health Answers

Echogenic bowel

Echogenic bowel refers to the scan finding of brighter than usual bowel. The terms ‘hyperechoeic bowel’ and even ‘hyperechogenic bowel’ are sometimes used to mean the same thing.

Normally bowel appears grey. This is the case with most soft tissue. Bone appears brighter, almost white. When the appearances of some sections of the bowel appear as bright or even brighter than bone, this will be described as ‘echogenic’.

In the second trimester, echogenic bowel is seen in up to 1.4% of all babies or 1 in 70. Typically, the areas affected will appear with the same (or more) brightness as the iliac bone in the baby’s pelvis.

Many conditions have been associated with the finding of echogenic bowel in the second trimester. These include chromosomal anomalies (aneuploidy) such as Down’s; cystic fibrosis, thalassaemia, intrauterine growth restriction (IUGR), viral and other infections including parvovirus, CMV and toxoplasmosis. Crucially however, most babies found to have echogenic bowel in isolation will be normal with none of the above conditions. In any case, presence of echogenic bowel on a second trimester scan should trigger a detailed scan to carefully look for other markers at the very least. If the woman has another risk factor for Down’s syndrome (advanced age or family history), a diagnostic test such as amniocentesis should be offered.

It is important to be aware that echogenic bowel in the final weeks of pregnancy in the third trimester is much more common and does not carry anywhere near the same degree of significance.

Next page: Renal pelvis dilatation

Echogenic bowel: You can clearly see that the brightness of the bowel here is comparable to that of the bony spine on top