Fetal midgut volvulus is quite rare, and most cases are associated with abnormalities of intestinal rotation or fixation. We report a case of midgut volvulus without malrotation, associated with a meconium pellet, dur...Fetal midgut volvulus is quite rare, and most cases are associated with abnormalities of intestinal rotation or fixation. We report a case of midgut volvulus without malrotation, associated with a meconium pellet, during the gestation period. This 2.79 kg, 33-wk infant was born via a spontaneous vaginal delivery caused by preterm labor. Prenatal ultrasound showed dilated bowel loops with the appearance of a 'coffee bean sign'. This patient had an unusual presentation with a distended abdomen showing skin discoloration. An emergency laparotomy revealed a midgut volvulus and a twisted small bowel, caused by complicated meconium ileus. Such nonspecific prenatal radiological signs and a low index of suspicion of a volvulus during gestation might delay appropriate surgical management and result in ischemic necrosis of the bowel. Preterm labor, specific prenatal sonographic findings (for example, the coffee bean sign) and bluish discoloration of the abdominal wall could suggest intrauterine midgut volvulus requiring prompt surgical intervention.展开更多
Jejunal diverticulosis is uncommon and often asymptomatic.It can produce significant complications,and some complications are potentially life threatening and require early surgical treatment,such as obstruction,hemor...Jejunal diverticulosis is uncommon and often asymptomatic.It can produce significant complications,and some complications are potentially life threatening and require early surgical treatment,such as obstruction,hemorrhage and perforation.There is no consensus on the management of this disease.Only a few cases of jejunal diverticulosis with midgut volvulus have been reported.We herein report a case of 57-year-old woman with jejunal diverticulosis causing small bowel volvulus who complained of intermittent upper abdominal pin-prick for 5 years that eventually progressed to a complete obstruction.The computed tomography scans revealed a mesenteric vessel "whirlpool" and laparotomy showed midgut volvulus secondary to jejunal diverticula.This case highlights jejunal diverticulosis causing small bowel volvulus as an uncommon mechanism of small bowel obstruction,which should be included in the differential diagnosis of small bowel obstruction.展开更多
Midgut volvulus is a clinical rare condition which appears as recurrent intermittent abdominal pain after consumption of food with intermittent colicky pain and sometimes with completely asymptomatic period. This gut ...Midgut volvulus is a clinical rare condition which appears as recurrent intermittent abdominal pain after consumption of food with intermittent colicky pain and sometimes with completely asymptomatic period. This gut twist may result in complications such as ischemia, obstruction, hemorrhage, or perforation. In the yolk sac during the third week of intrauterine life, there is normal communication with intraembryonic gut. During development proceeds, this communication gets thinner into a tube known as the vitellointestinal duct. Vitellointestinal duct usually becomes obliterated before eighth week of intrauterine life. In about 2% of people this duct persists and gives rise to a group of anomalies such as Meckel’s diverticulum is the commonest and complete patency of the duct is the rarest. Here we present the case of a 34-year-old male who presented with both conditions.展开更多
BACKGROUND Congenital malrotation of the intestine is characterized by an abnormality in intestinal anatomy and mesenteric fixation resulting from disordered rotation of the intestine around the mesenteric artery duri...BACKGROUND Congenital malrotation of the intestine is characterized by an abnormality in intestinal anatomy and mesenteric fixation resulting from disordered rotation of the intestine around the mesenteric artery during embryonic life.This disease can cause intestinal torsion,intestinal obstruction and other acute abdominal symptoms.CASE SUMMARY A 23-year-old female patient was admitted to our hospital on January 11,2024,with a history of recurrent periumbilical pain for over 10 years and worsening for 6 months.In this report,the patient was diagnosed with a congenital midgut malrotation with herniation of the jejunum into a malformed omentum in surgery.The patient developed a hernia sac of the omentum adjacent to the duodenum,with the upper jejunum herniating to form an intra-abdominal hernia.During surgery,the jejunum-ileum and ileocecal junction were positioned according to their normal anatomy,and the mesentery root was linearly fixed to the posterior abdominal wall.Ascending colon and right transverse colon were repositioned in their normal anatomical locations.The patient was monitored for more than 1 year post-surgery and recovered well with no signs of abdominal pain or distension.CONCLUSION Congenital midgut reverse transposition is a specific malrotation of the intestine that is often found in adulthood.It is prone to forming intra-abdominal epiploic hernias.Personalized surgical treatment can achieve better results.展开更多
文摘Fetal midgut volvulus is quite rare, and most cases are associated with abnormalities of intestinal rotation or fixation. We report a case of midgut volvulus without malrotation, associated with a meconium pellet, during the gestation period. This 2.79 kg, 33-wk infant was born via a spontaneous vaginal delivery caused by preterm labor. Prenatal ultrasound showed dilated bowel loops with the appearance of a 'coffee bean sign'. This patient had an unusual presentation with a distended abdomen showing skin discoloration. An emergency laparotomy revealed a midgut volvulus and a twisted small bowel, caused by complicated meconium ileus. Such nonspecific prenatal radiological signs and a low index of suspicion of a volvulus during gestation might delay appropriate surgical management and result in ischemic necrosis of the bowel. Preterm labor, specific prenatal sonographic findings (for example, the coffee bean sign) and bluish discoloration of the abdominal wall could suggest intrauterine midgut volvulus requiring prompt surgical intervention.
文摘Jejunal diverticulosis is uncommon and often asymptomatic.It can produce significant complications,and some complications are potentially life threatening and require early surgical treatment,such as obstruction,hemorrhage and perforation.There is no consensus on the management of this disease.Only a few cases of jejunal diverticulosis with midgut volvulus have been reported.We herein report a case of 57-year-old woman with jejunal diverticulosis causing small bowel volvulus who complained of intermittent upper abdominal pin-prick for 5 years that eventually progressed to a complete obstruction.The computed tomography scans revealed a mesenteric vessel "whirlpool" and laparotomy showed midgut volvulus secondary to jejunal diverticula.This case highlights jejunal diverticulosis causing small bowel volvulus as an uncommon mechanism of small bowel obstruction,which should be included in the differential diagnosis of small bowel obstruction.
文摘Midgut volvulus is a clinical rare condition which appears as recurrent intermittent abdominal pain after consumption of food with intermittent colicky pain and sometimes with completely asymptomatic period. This gut twist may result in complications such as ischemia, obstruction, hemorrhage, or perforation. In the yolk sac during the third week of intrauterine life, there is normal communication with intraembryonic gut. During development proceeds, this communication gets thinner into a tube known as the vitellointestinal duct. Vitellointestinal duct usually becomes obliterated before eighth week of intrauterine life. In about 2% of people this duct persists and gives rise to a group of anomalies such as Meckel’s diverticulum is the commonest and complete patency of the duct is the rarest. Here we present the case of a 34-year-old male who presented with both conditions.
文摘BACKGROUND Congenital malrotation of the intestine is characterized by an abnormality in intestinal anatomy and mesenteric fixation resulting from disordered rotation of the intestine around the mesenteric artery during embryonic life.This disease can cause intestinal torsion,intestinal obstruction and other acute abdominal symptoms.CASE SUMMARY A 23-year-old female patient was admitted to our hospital on January 11,2024,with a history of recurrent periumbilical pain for over 10 years and worsening for 6 months.In this report,the patient was diagnosed with a congenital midgut malrotation with herniation of the jejunum into a malformed omentum in surgery.The patient developed a hernia sac of the omentum adjacent to the duodenum,with the upper jejunum herniating to form an intra-abdominal hernia.During surgery,the jejunum-ileum and ileocecal junction were positioned according to their normal anatomy,and the mesentery root was linearly fixed to the posterior abdominal wall.Ascending colon and right transverse colon were repositioned in their normal anatomical locations.The patient was monitored for more than 1 year post-surgery and recovered well with no signs of abdominal pain or distension.CONCLUSION Congenital midgut reverse transposition is a specific malrotation of the intestine that is often found in adulthood.It is prone to forming intra-abdominal epiploic hernias.Personalized surgical treatment can achieve better results.
