Pediatric idiopathic midgut volvulus and shock in the infant

Authors

  • Juliana Maciel Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto http://orcid.org/0000-0003-4711-8842
  • Ana Luisa Santos Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto
  • Ana Sofia Marinho Department of Pediatric Surgery, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto
  • Suzana Figueiredo Department of Pediatrics, Hospital de Santa Luzia, Unidade Local de Saúde do Alto Minho
  • Ana Rita Araújo Department of Pediatrics, Hospital de Santa Luzia, Unidade Local de Saúde do Alto Minho
  • Hélder Morgado Department of Pediatric Surgery, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto
  • Banquart Leitão Department of Pediatric Surgery, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto
  • Alzira Sarmento Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto
  • Sofia Ribeiro Fernandes Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto
  • Paula Regina Ferreira Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v29.i4.18738

Keywords:

idiopathic, infant, intestinal volvulus, shock

Abstract

Introduction: Intestinal volvulus is a surgical emergency in which a segment of the intestine twists over its mesenteric attachment, causing bowel obstruction. It usually presents with bilious vomiting and can progress to bowel necrosis and shock.
Case Report: A 40-days-old male infant presented with acute onset irritability, bilious vomiting, abdominal distention, and hematochezia. He rapidly evolved to shock with metabolic acidosis and coagulopathy, requiring fluid resuscitation, vasoactive agents, and invasive mechanical ventilation. The patient was submitted to urgent laparotomy, confirming midgut volvulus without malrotation. Partial reperfusion of the affected midgut was achieved, with no resection initially performed, but 48 hours later he was re-evaluated and partial enterectomy for midgut necrosis was performed. Despite the condition´s severity, the patient had a good evolution with full recovery.
Discussion: Bilious vomiting in the infant is highly suggestive of intestinal obstruction. The authors emphasize the presence of midgut volvulus without malrotation, complicated with bowel necrosis and shock.

Author Biographies

Juliana Maciel, Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Serviço de Neonatologia e Cuidados Intensivos Pediátricos, Unidade de Cuidados Intensivos Pediátricos, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto.

Ana Luisa Santos, Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Serviço de Neonatologia e Cuidados Intensivos Pediátricos, Unidade de Cuidados Intensivos Pediátricos, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto.

Ana Sofia Marinho, Department of Pediatric Surgery, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Serviço de Cirurgia Pediátrica, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Suzana Figueiredo, Department of Pediatrics, Hospital de Santa Luzia, Unidade Local de Saúde do Alto Minho

Serviço de Pediatria, Unidade Local de Saúde do Alto Minho

Ana Rita Araújo, Department of Pediatrics, Hospital de Santa Luzia, Unidade Local de Saúde do Alto Minho

Serviço de Pediatria, Unidade Local de Saúde do Alto Minho.

Hélder Morgado, Department of Pediatric Surgery, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Serviço de Cirurgia Pediátrica, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Banquart Leitão, Department of Pediatric Surgery, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Serviço de Cirurgia Pediátrica, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Alzira Sarmento, Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Serviço de Neonatologia e Cuidados Intensivos Pediátricos, Unidade de Cuidados Intensivos Pediátricos, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Sofia Ribeiro Fernandes, Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Serviço de Neonatologia e Cuidados Intensivos Pediátricos, Unidade de Cuidados Intensivos Pediátricos, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Paula Regina Ferreira, Neonatal Unit and Department of Pediatric Intensive Care, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

Serviço de Neonatologia e Cuidados Intensivos Pediátricos, Unidade de Cuidados Intensivos Pediátricos, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto

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Published

2020-11-26

How to Cite

Maciel, J. ., Santos, A. L., Marinho, A. S., Figueiredo, S., Araújo, A. R., Morgado, H., Leitão, B., Sarmento, A., Fernandes, S. R., & Ferreira, P. R. (2020). Pediatric idiopathic midgut volvulus and shock in the infant. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 29(4), 212–214. https://doi.org/10.25753/BirthGrowthMJ.v29.i4.18738

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Section

Case Reports

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