Delayed diagnosis of bowel infarction secondary to maternal midgut volvulus at term.
BACKGROUND:Intestinal volvulus is responsible for 25% of acute bowel obstructions in pregnant women but only 3-5% in nonpregnant patients. Pregnancy may hinder early diagnosis. CASE:A woman in early labor subsequently developed hypotension and a nonreassuring fetal heart rate tracing. Emergency cesarean was performed and a live infant was born. At surgery, the patient was noted to have ascites, necrotic bowel, and a congenital gut malrotation with a complete midgut volvulus. Several congenital peritoneal bands were lysed, the volvulus was reduced, and 184 cm of small bowel were resected. CONCLUSION:This patient represents a case of midgut volvulus with bowel infarction and necrosis secondary to congenital malrotation of the gut.
Ventura-Braswell, AM; Satin, AJ; Higby, K
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