Sentinel bowel loop as a marker for primary segmental intestinal volvulus in extreme low birth weight neonates

Author:

Zahouani Tarik1,Carter William R.2,Jessel Rebecca H.3,El-Metwally Dina E.1,Crowley Helena M.4

Affiliation:

1. Division of Neonatology, Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD, USA

2. Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore, MD, USA

3. Division of Maternal Fetal Medicine, University of Maryland Medical Center, Baltimore, MD, USA

4. Division of Pediatric Surgery and Urology, University of Maryland Medical Center, Baltimore, MD, USA

Abstract

Primary segmental intestinal volvulus is a rare condition that may affect neonates. This condition occurs when a loop of bowel torses around the axis of its mesentery without any other abnormality or malrotation. In the earlier stages, the diagnosis can be challenging due to the lack of specific clinical and radiographic signs. Prompt surgical management is critical as a delay in diagnosis may result in bowel loss or death. We present a series of three cases of extremely low birth weight infants with primary segmental volvulus. A sentinel bowel loop was critical in guiding each patient’s surgical management as there were no other clinical markers concerning a pending intra-abdominal catastrophe. This case series suggests that a sentinel bowel loop may be a radiographic marker for primary segmental intestinal volvulus in extremely low birth weight infants.

Publisher

IOS Press

Subject

Pediatrics, Perinatology and Child Health

Reference13 articles.

1. Volvulus of the entire small bowel with normal bowel fixation simulating malrotation and midgut volvulus;Shah;Pediatr Radiol,2015

2. Primary segmental intestinal volvulus in a neonate;Erikci;Indian Pediatr,2019

3. A neonate with intestinal volvulus without malrotation exhibiting early jaundice with a suspected fetal onset;Hara;Turk J Pediatr,2015

4. Primary segmental volvulus of small intestine: surgical perspectives according to age at diagnosis;Kim;Front Pediatr,2019

5. Primary segmental volvulus mimicking ileal atresia;Shankar;J Neonatal Surg,2013

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