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SUMMARY: Hara K, Kinoshita M, Kin T, Arimitsu T, Matsuzaki Y, Ikeda K, Tomita H, Fujino A, Kuroda T. A neonate with intestinal volvulus without malrotation exhibiting early jaundice with a suspected fetal onset. Turk J Pediatr 2015; 57: 418-421.
Intestinal volvulus without malrotation is a rare disease that causes volvulus of the small intestine despite normal intestinal rotation and fixation. We encountered a neonate with this disease who developed early jaundice and was suspected to have a fetal onset. This patient was characterized by early jaundice complicating intestinal volvulus without malrotation and is considered to have exhibited reduced fetal movement and early jaundice as a result of volvulus, necrosis, and hemorrhage of the small intestine in the fetal period. If abdominal distention accompanied by early jaundice is noted in a neonate, intestinal volvulus without malrotation and associated intraabdominal hemorrhage should be suspected and promptly treated.
Key words: intestinal volvulus, early jaundice, fetal onset.
Intestinal volvulus without malrotation is a rare disease that causes volvulus of the small intestine despite normal intestinal rotation and fixation. While it is observed at all ages from neonates to adults, it occurs most frequently in the neonatal period. The prognosis depends on early diagnosis and treatment, but, in neonates, it lacks characteristic findings and is difficult to diagnose. We encountered a neonate with intestinal volvulus without malrotation showing early jaundice and marked abdominal distention, suspected to have a fetal onset.
Case Report
The patient was a 0-day-old girl who had shown reduced fetal movement since the 35th week of gestation. Since a decrease in variability was noted on cardiotocography at 35 weeks and 6 days of gestation, the infant was born by emergency Caesarean section. The birth weight was 2,136 g, and the Apgar score was 9/10. Since retractive breathing and abdominal distention persisted at 1 hour after birth, the infant was transferred to our hospital.
On arrival, fever, tachypnea, and hypoxemia were noted. The infant was lethargic, the skin of the entire body was pale, and retractive breathing was observed. The abdomen was hard and distended, and no bowel sound was heard. Initial laboratory values revealed a hemoglobin level...