Intestinal volvulus in utero causing torsion of dilated bowel with ileal atresia: a case report

• Published in: Surgical case reports Vol. 9; no. 1; p. 65
• Main Authors: Toyama, Chiyoshi, Segawa, Yuki, Iijima, Shigeo, Murakoshi, Takeshi, Nara, Keigo
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 25.04.2023; Springer Nature B.V; SpringerOpen
• Subjects: Abdomen; Ascites; Case Report; Case reports; Cesarean section; Dilated bowel; Feces; Hospitals; In utero; Intestinal atresia; Intestinal volvulus; Laparotomy; Medicine; Medicine & Public Health; Nutrition; Ostomy; Parenteral nutrition; Peritonitis; Small intestine; Surgery; Surgical outcomes; Torsion; Ultrasonic imaging; Intestinal atresia; Intestinal volvulus; Dilated bowel; In utero; Torsion
• ISSN: 2198-7793; 2198-7793
• DOI: 10.1186/s40792-023-01645-4

Background In utero intestinal volvulus with intestinal atresia is a rare and life-threatening condition that can cause torsion of the dilated bowel. The management and outcomes of this disease remain unclear. Case presentation A 19-year-old woman noticed a decrease in fetal motion at 35 weeks. Fetal ultrasound showed dilated fetal bowel and the whirlpool sign. The patient was referred to our hospital for an emergency cesarean section. The neonate’s abdomen was dark and severely distended, and a laparotomy was performed. Necrotic ileum and cord-type intestinal atresia (Type II) were observed in the dilated terminal ileum. The necrotic ileum was resected, and a second-look surgery was performed the following day. Then, we anastomosed the remaining intestine, and the total intestine length was 52 cm. There were no surgical complications, and the patient was discharged without requiring total parenteral nutrition or fluid infusion. The patient’s height and weight were within the − 2 standard deviation range of the growth curve at 5 months. Conclusions Emergency and appropriate management of intestinal volvulus in utero causing torsion of the dilated bowel resulted in good outcomes in a patient with intestinal atresia. Perinatal physicians should be aware of this emergency condition and plan their treatment approach accordingly.