Abstract

BackgroundIntrauterine midgut volvulus is a very rare, life-threatening condition, and prenatal diagnosis is difficult. In this article, we present a case of midgut volvulus followed by a pre-diagnosis of antenatal jejunal atresia.Case presentationA 1-day-old Turkish male baby, who was followed with a diagnosis of antenatal jejunal atresia, with a birth weight of 3600 g, delivered by cesarean section at 38 weeks of gestation from a 19-year-old mother in her fourth pregnancy, was taken to the newborn intensive care unit. The patient underwent surgery on the postnatal first day with a preliminary diagnosis of jejunal atresia. It was observed that the small intestine was rotated two full cycles from the mesenteric root. Bowel blood circulation was good. Volvulus was untwisted. There was malrotation. Ladd's procedure was performed. The baby was discharged on the seventh postoperative day with full oral feeding. The patient is still in the first postoperative year and follow-up has been uneventful.ConclusionIntrauterine midgut volvulus has been associated with high mortality in the literature. Differential diagnosis of midgut volvulus in patients with antenatal intestinal obstruction, close prenatal follow-up, appropriate delivery and timing of surgical intervention may significantly reduce morbidity and mortality.

Highlights

  • Intrauterine midgut volvulus is a very rare, life-threatening condition, and prenatal diagnosis is difficult

  • Intrauterine midgut volvulus has been associated with high mortality in the literature

  • Small bowel volvulus occurs when bowel loops become twisted around the mesenteric artery or its branches

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Summary

Conclusion

Prenatal suspicion and/or diagnosis of intestinal volvulus is essential for newborn outcome, given the association with high mortality in the literature. The presented case had good results, differential diagnosis of midgut volvulus in patients with antenatal intestinal obstruction, close prenatal follow-up, and appropriate delivery and timing of surgical intervention may significantly reduce morbidity and mortality

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