Publication Date
6-1-2023
Journal
Journal of Pediatric Surgery Case Reports
DOI
10.1016/j.epsc.2023.102654
PMID
37292252
PMCID
PMC10249907
PubMedCentral® Posted Date
6-8-2023
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Malrotation, Volvulus, Whirlpool sign
Abstract
INTRODUCTION: Malrotation of the intestinal tract is a congenital malformation commonly found either incidentally or after affected individuals develop signs and symptoms of intestinal obstruction. Malrotation is prone to midgut volvulus that can cause intestinal obstruction and lead to ischemia and necrosis requiring emergent surgical intervention. Rare instances of
CASE PRESENTATION: This case report details an interesting presentation of intestinal malrotation with suspected midgut volvulus found on prenatal imaging at 33 weeks and 4 days' gestation. This prompted delivery of the infant at 34 weeks and 2 days' gestation with urgent operative management, within 3 hours of life, after diagnosis was confirmed postnatally. Intraoperatively, the infant was confirmed to have midgut volvulus without bowel ischemia, the intestines were reduced, and a Ladd procedure was performed without incident. The infant recovered postoperatively without complication, tolerated advancement to full volume feeds and was discharged on day of life 18.
CONCLUSION: Successful management of fetal malrotation with midgut volvulus may be accomplished by early access to a multi-disciplinary team of professionals, prompt postnatal confirmation of diagnosis, and urgent correction to minimize the risk of complications.