Korean J Perinatol.  2015 Jun;26(2):134-138. 10.14734/kjp.2015.26.2.134.

A Case of a Preterm Infant with Prenatally Diagnosed Intrauterine Midgut Volvulus

• Woo HK
• Lee HY
• Kim SY
• Jung YH
• Shin SH
• Kim HY
• Kim EK
• Kim HS
• Jun JK
• Choi JH

• KMID: 1896938
• DOI: http://doi.org/10.14734/kjp.2015.26.2.134

Abstract

Intrauterine midgut volvulus is a rare and potentially life-threatening congenital disease that can lead to intestinal ischemia, sepsis and peritonitis caused by bowel perforation and meconium obstruction. Early detection and immediate treatment is crucial to improve the outcome. Herein, we report a preterm infant of 30 weeks of gestation with intrauterine midgut volvulus associated with meconium peritonitis who survived after cesarean delivery and immediate postnatal surgical intervention. The outcome of in-utero intestinal volvulus depends on optimal delivery timing and adequate postnatal treatment. Therefore, prompt multidisciplinary consultation and planning with obstetricians, neonatologists and pediatric surgeons is necessary to reduce the morbidity and mortality associated with fetal midgut volvulus, especially in the preterm period.

Keyword

Intrauterine midgut volvulus; Meconium peritonitis; Antenatal diagnosis; Preterm infant

MeSH Terms

Humans
Infant, Newborn
Infant, Premature*
Intestinal Volvulus*
Ischemia
Meconium
Mortality
Peritonitis
Pregnancy
Prenatal Diagnosis
Sepsis

Figure

• 

  Fig. 1. Fetal ultrasonography at 29+4 of gestation showed the ‘whirlpool sign' (arrow).

• 

  Fig. 2. At birth, the abdomen was distended, and the skin was discolored with visible peristalsis.

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  Fig. 3. Intra-operative finding showed a midgut volvulus with necrosis and perforation (arrow).

Reference

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