 Hi everyone, I am Dr. Karen Masclinas and I am a second year radiology resident at Shreem Pishaa Government Medical College, Chandnagar. And I am here to present my paper on anomalies of the fetal gastrointestinal tract. Introduction. Anomalies of the fetal cardiovascular system are most prevalent, followed by the central nervous system. In the gastrointestinal system, the most prevalent are the errors of rotation. Presented here are few GI anomalies and their appearance on antinatal ultrasonography. My aims and objectives are to evaluate the utility of prenatal ultrasonography for fetal gastrointestinal abnormalities and to find out their characteristics. Materials and methods. Samsung RS-80 Evo ultrason machine was used. Methodology. Pregnant females referred to us by obstetrics and gynecology department underwent routine antinatal ultrasonography. Four patients with different fetal gastrointestinal tract pathologies were diagnosed. And findings conveyed to the respective obstetrics and gynecology department. My results are as follows. The first case is of impoverished anus, in which the ultrasonography findings are dilatation of bowel loops and anhydroneus. Second, deodorant atresia, in which we found double bubble sign as a result of an enlarged stomach and deodorant cap. Third, fetal gallstones, in which multiple echogenic focci within the gallbladder were found. And unfollowing, a herniation of bowel loops and liver into a membrane-cover defect was found. Discussion. First case. A 30-year-old G2P1A0L1, whose estimated gestational age was 17 weeks and one day, came for routine ultrasonography and a findings work, dilatation of bowel loops, 7mm in maximum transverse diameter and anhydroneus. Here are the images showing the dilated bowel loops and in relation with the reuring of the bladder. On rose examination of the terminated fetus, anal opening was found to be closed and right lower limb was found to be deformed as shown below. Impoverished anus. Common congenital malformation that is caused by hangar development defects or retardation. In association with bacterial abnormalities, standing for vertebral anomalies, anal atrasia, cardiac anomalies, tracheoesophageal pistula with esophageal atrasia, renal anomalies and lymph anomalies. Indirect findings are dilated bowel segments and calcified intraluminal meconium in second and third trimester. Some direct findings are no perianal muscular complex and no target sign, signified by a hypoechoic anal sphincter and an echogenic anal mucosa. It is shown in the image below. My second case, a 30-year-old G2P1A0L1 whose estimated gestational age was 20 weeks, 6 days, came for routine antinatal ultrasonography and findings were dilated stomach and eodinum giving the double pupil sign and lycra which was in the upper limit of normal single deepest pocket being 7.1 centimeter in diameter. And the images shown are of a transverse section of abdomen and a coronal section showing the dilated stomach and eodinum and giving the double pupil sign. Eodinal atrasia is the failure of recanalization of the bowel lumen that is the eodinum in fetal life. The double pupil sign is a result of an enlarged stomach and eodinal cap and is generally found more than 24 weeks of gestation in association with polyhydramneus which is also found in more than 24 weeks gestation in 50% of cases. Differential diagnosis are kooledocal cyst which is seen closer to the liver and in continuity with gall bladder or hepatic ducts. Omental cyst typically seen closer to the anterior abdominal wall and enteric duplication cyst which will be seen separate from the bladder and stomach. My third case, a 24 year old G1P1A0L0 whose estimated gestational age was 36 weeks 5 days and came for routine antinatal atrasomography and the findings on sonography were multiple echogenic focci within the gall bladder. The image shown below shows the echogenic focci, a cluster of tiny juxtahepatic echogenic focci. So fetal gall stones are seen as a cluster of echogenic juxtahepatic focci, shadowing as well as comet tail artifacts may also be seen. Gall bladder sludge, gall bladder may be diffusely echogenic in gall bladder sludge. It is difficult to distinguish true sludge from multiple small stones. Associations, hemolytic conditions of the newborn and maternal hemolytic anemia. Differential diagnoses are juxtahepatic calcification from meconium peritonitis in utero fetal infections and in utero calcified hematoma of the liver close to the periphery towards the gall bladder. My fourth case, a 26 year old G1P1A0L0 whose estimated gestational age was 20 weeks 1 day came for routine antinatal atrasomography and on sonography the findings were a midline anterior abdominal wall defect with herniating large membrane covered sac containing bowel loops and liver. And the images are of a sagittal section of abdomen showing the anterior abdominal wall defect with herniation of bowel loops and liver and you can see the umbilical cord attached to the sac. Umphalocele, it is a congenital midline abdominal wall defect at the base of the umbilical cord insertion with herniation of gut or occasional yet the structures out of the fetal abdomen. It has a high association with anomalies. Multiple bowel loops and occasion liver herniate into the membrane covered defect. It is not free flowing and are usually seen as hyper echogenic content which is non fluid filled bowel. The umbilical cord insertion is directly into the umphalocele. Its differential diagnosis is gastrolysis and it can be differentiated by its site which is umbilical in umphalocele and para umbilical in gastrolysis. The sac is always present in umphalocele and absent in gastrolysis and associated anomalies are common in umphalocele while rare in gastrolysis. And the images are attached below differentiating umphalocele with gastrolysis. In conclusion, fetal gastrointestinal tract abnormalities are relatively uncommon and a high degree of suspicion is required for their diagnosis. Thank you.