In-utero segmental volvulus around vitellointestinal duct remnants leading to ileal atresia and stenosis: A case series

Vidyanand Deshpande,Rajgopal Totla,Arjun Pawar,Pravin Suryawanshi

doi:10.47338/jns.v9.522

Vidyanand Deshpande, Rajgopal Totla + Show 2 more

Open Access

https://doi.org/10.47338/jns.v9.522

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Abstract

Background: The etiology of intestinal atresia is multifactorial with vascular accidents being the most common event in its development. In-utero volvulus is a well-known type of vascular accident leading to intestinal atresia. Segmental volvulus around vitellointestinal duct remnants is rarely described vascular accident leading to ileal atresia. Case Series: We report two cases of segmental ileal volvulus around vitellointestinal duct remnants in neonates leading to ileal atresia in one case and intestinal stenosis in the other one. Both neonates presented with signs of neonatal intestinal obstruction. X-ray abdomen performed in both neonates showed air-fluid levels. Both neonates were operated with suspicion of intestinal atresia. At surgery, a segment of the small bowel was found twisted around vitellointestinal duct remnants in both cases. The first case also had intestinal atresia whereas the second one had intestinal stenosis secondary to the segmental volvulus. Conclusion: Segmental volvulus around vitellointestinal duct remnants can also cause ileal atresia or stenosis.

Highlights

Vascular accidents leading to ischemic necrosis and subsequent resorption of the affected segment of the ileum are thought to be predisposing factors in the majority of cases of ileal atresia.[1]
Intrauterine segmental volvulus occasionally occurs around vitellointestinal duct (VID) remnants
We present two such cases of segmental volvulus around VID remnants in neonates, both being diagnosed as ileal atresia pre-operatively

Summary

Introduction

Vascular accidents leading to ischemic necrosis and subsequent resorption of the affected segment of the ileum are thought to be predisposing factors in the majority of cases of ileal atresia.[1]. Conclusion: Segmental volvulus around vitellointestinal duct remnants can cause ileal atresia or stenosis. Vascular accidents leading to ischemic necrosis and subsequent resorption of the affected segment of the ileum are thought to be predisposing factors in the majority of cases of ileal atresia.[1] Segmental volvulus is the twisting of a bowel loop, around a fixed structure, along the axis of its mesentery.[2] Intrauterine segmental volvulus occasionally occurs around vitellointestinal duct (VID) remnants. We present two such cases of segmental volvulus around VID remnants in neonates, both being diagnosed as ileal atresia pre-operatively.

Results

Conclusion