Abstract
A 2-day-old, full-term female presented for evaluation of recent-onset bilious emesis. Upper gastrointestinal imaging showed twisting in the second and third portions of the duodenum with the fourth portion of the duodenum and the jejunum to the right of midline consistent with malrotation of the small bowel. Lack of contrast beyond the proximal jejunum was concerning for volvulus (Fig. 1). Emergent laparotomy confirmed intestinal malrotation with complete volvulus of the midgut in a 360° turn. Derotation was performed in a counterclockwise fashion, restoring blood flow and venous return to the small bowel. Appendectomy and division of Ladd's bands covering the cecum and jejunum were performed. The intestines were found to be viable. The colon was returned to the left side of the abdomen with the cecum placed in the left upper quadrant, and the small bowel was returned to the right side. The patient's postoperative course was uneventful and she was initiated on oral feeds on postoperative Day 3. She was discharged to home once she was tolerating full feeds.
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