scholarly journals Fetal Midgut Volvulus with Meconium Peritonitis Detected on Prenatal Ultrasound

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Emanuelle J. Best ◽  
Cecelia M. O’Brien ◽  
Wendy Carseldine ◽  
Aniruddh Deshpande ◽  
Rebecca Glover ◽  
...  
Keyword(s):  
Small Bowel ◽  
Abdominal Mass ◽  
Uneventful Recovery ◽  
Team Approach ◽  
Midgut Volvulus ◽  
Meconium Peritonitis ◽  
Third Trimester ◽  
Bowel Necrosis ◽  
Threatening Condition ◽  
Life Threatening

Background. Fetal volvulus is a rare, yet life-threatening condition that requires skilful diagnosis and management. Volvulus occurs when bowel loops become twisted and the twisting of the mesenteric artery leads to congestion, impaired venous return, and bowel necrosis. Case Description. We present a case of fetal ileal volvulus suspected on third trimester ultrasound, complicated by premature labour, small bowel necrosis, and meconium peritonitis. Progressive dilatation and decreased peristalsis of echogenic bowel were noted in the early part of the third trimester. Daily surveillance ultrasound was performed and spontaneous labour occurred at 32 weeks’ gestation. A proactive postnatal approach guided by prenatal sonographic findings allowed prompt treatment and an urgent laparotomy was performed for an ileal volvulus with necrosis and meconium peritonitis. A segment of small bowel volvulus was resected and an end-to-end anastomosis was performed with uneventful recovery. Discussion. Clinically signs of fetal midgut volvulus are not pathognomonic, such as intestinal dilatation, abdominal mass, ascites, peritoneal calcifications, or polyhydramnios; thus, the diagnosis is often challenging. Complications reported in the literature include perforation and haemorrhagic ascites, which may lead to anaemia, hypovolemia, heart failure, and fetal demise. Conclusion. This case highlights the importance of assessing the fetal bowel as a part of routine third trimester ultrasound. The case describes the complexity of diagnosis in the fetus, important considerations along with multidisciplinary team approach to management.

Midgut volvulus secondary to congenital malrotation in pregnancy

2020 ◽  
Vol 13 (5) ◽  
pp. e234664 ◽  
Author(s):  
Eelyn Chong ◽  
David S Liu ◽  
Vishnupriya Rajagopal ◽  
Neil Strugnell
Keyword(s):  
Perinatal Outcomes ◽  
First Trimester ◽  
Small Bowel Resection ◽  
Emergency Laparotomy ◽  
Midgut Volvulus ◽  
Threatening Condition ◽  
Life Threatening ◽  
Uncommon Condition ◽  
Adverse Perinatal Outcomes ◽  
In Pregnancy

Midgut volvulus complicating congenital malrotation is a rare but life-threatening condition that can occur in pregnancy. We present a case of intestinal infarction resulting from midgut volvulus in a healthy 32-week pregnant woman who underwent emergency laparotomy and small bowel resection in the setting of fetal death in utero. This case highlights several challenging issues in diagnosing and managing this uncommon condition which leads to increased adverse perinatal outcomes. Prompt investigation and definitive surgical treatment are required when pregnant women present with bilious vomiting and new-onset abdominal or back pain especially beyond the first trimester.

scholarly journals Late traumatic diaphragmatic rupture complicated by haemothorax and strangulation of the stomach: A case report

2020 ◽  
Vol 48 (6) ◽  
pp. 030006052093086
Author(s):  
Jian-Chun Xiao ◽  
Li-Yuan Ma ◽  
Bing-Lu Li
Keyword(s):  
Penetrating Trauma ◽  
Diaphragmatic Rupture ◽  
Uneventful Recovery ◽  
Trauma Symptoms ◽  
Traumatic Diaphragmatic Rupture ◽  
Left Pleural Effusion ◽  
Threatening Condition ◽  
Diaphragmatic Repair ◽  
Life Threatening ◽  
High Index Of Suspicion

Traumatic diaphragmatic rupture (TDR) is an uncommon but life-threatening condition often caused by blunt or penetrating trauma. Symptoms may appear late resulting in delayed or missed diagnosis. We report here a case of a 28-year-old man who presented with left subcostal pain and vomiting after recently binge drinking alcohol. He had experienced bilateral rib fractures two years previously. Computed tomography (CT) showed massive left pleural effusion and pleural fluid drained by thoracentesis had a bloody appearance. The patient developed septic shock but emergency surgery showed no active bleeding. Enhanced-CT showed herniated stomach with ischemic necrosis in the left thoracic cavity. Total gastrectomy and diaphragmatic repair were successful and the patient had an uneventful recovery. A high index of suspicion is necessary when evaluating haemothorax, especially in patients with recent or previous thoraco-abdominal injury.

scholarly journals Laparoscopic Treatment of a Rare Right Diaphragmatic Rupture with Small Bowel Herniation after Blunt Thoracic Trauma

2010 ◽  
Vol 2010 ◽  
pp. 1-2 ◽  
Author(s):  
H. Hoffmann ◽  
D. Oertli ◽  
O. Heizmann
Keyword(s):  
Small Bowel ◽  
Laparoscopic Approach ◽  
Diaphragmatic Rupture ◽  
Laparoscopic Treatment ◽  
Diaphragm Rupture ◽  
Traumatic Diaphragmatic Rupture ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Right ◽  
Delay Of Diagnosis

Blunt traumatic diaphragmatic rupture (BTDR) is a life-threatening condition with an incidence from 0,8%–1,6% in blunt trauma, mostly located on the left side. The main prognostic factors are severe side injuries and the delay of diagnosis. We present a rare case of a 68-year-old female, with an isolated right diaphragm rupture. The diagnosis was done with a delay of 4 days by thoracic radiographs, which showed a herniation of small bowel into the right thoracic cavity. A reposition of the small bowel and a closure of the diaphragmatic defect by running suture were carried out laparoscopicly. Although large prospective studies concerning the outcome of laparoscopic approach to right BTDR are still missing, we could show, that laparoscopy can be performed safely in right traumatic diaphragm rupture.

scholarly journals RARE CASE OF FETAL MIDGUT VOLVULUS DETECTED BY WHIRPOOL SIGN ON ROUTINE ANTENATAL ULTRASOUND.

2021 ◽  
pp. 66-67
Author(s):  
Meghna Barmase
Keyword(s):  
Case Report ◽  
Poor Prognosis ◽  
Rare Case ◽  
Surgical Intervention ◽  
Midgut Volvulus ◽  
Antenatal Ultrasound ◽  
Caesarean Section Delivery ◽  
Threatening Condition ◽  
Life Threatening ◽  
Mesenteric Vessels

Fetal midgut volvulus is an extremely rare life threatening condition with poor prognosis. It often remains undiagnosed on antenatal ultrasound and manifest as intestinal obstruction in both antenatal and post natal period. Following is the case report of intrauterine midgut volvulus causing proximal obstruction of stomach and duodenum. The infant survived postnatally after caesarean section delivery with prompt and appropriate surgical intervention. Twisting of bowel loops around the mesenteric vessels suggestive of whirpool sign was the most signicant clue leading to the diagnosis of volvulus.

Paralysis from an ear infection: a severe case of otitis externa leading to acute complete cervical cord syndrome

2021 ◽  
Vol 14 (12) ◽  
pp. e245594
Author(s):  
Rachael Collins ◽  
George Lafford ◽  
Laura Parry
Keyword(s):  
Otitis Externa ◽  
Severe Case ◽  
Complete Recovery ◽  
Cervical Cord ◽  
Team Approach ◽  
Neck Stiffness ◽  
Threatening Condition ◽  
Life Threatening ◽  
History Of ◽  
Red Flag

We report a case of a generally fit and well 54-year-old man who presented with a 2-day history of worsening left-sided otorrhea, headache, neck stiffness, vomiting and fever on the background of a 7-week history of otitis externa (OE). His condition progressed dramatically as he developed symptoms consistent with acute complete cervical cord syndrome with radiological evidence of skull base osteomyelitis, parapharyngeal, retropharyngeal and paravertebral abscesses and sigmoid sinus thrombus. Ultimately, he made a significant, although not complete, recovery. This case is unique in demonstrating how OE can develop into a potentially life threatening condition. It emphasises the importance of early diagnosis and treatment of OE, the recognition of ‘red flag’ symptoms and highlights the importance of a multidisciplinary team approach when managing complex complications of OE.

Spontaneous resolution of fetal ascites secondary to gastrointestinal abnormality

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Alison Wiles ◽  
Melissa Yannetti ◽  
Cheryl Dinglas
Keyword(s):  
Small Bowel ◽  
Neonatal Outcome ◽  
Abdominal Mass ◽  
In Utero ◽  
Spontaneous Resolution ◽  
Meconium Peritonitis ◽  
Case Presentation ◽  
Favorable Prognosis ◽  
Normal Neonate ◽  
Gastrointestinal Abnormalities

Abstract Objectives Isolated fetal ascites carries an uncertain prognosis and broad differential diagnosis. When detected on prenatal sonography, a thorough evaluation is warranted to exclude development of hydrops and search for an underlying condition. While gastrointestinal abnormalities account for approximately 20% of cases of fetal ascites, surgical correction is commonly required postnatally. While there have been reports of isolated fetal ascites resolving in utero, spontaneous resolution of the causative gastrointestinal abnormality is unusual. Case presentation We report a case of a multiparous 33-year-old found to have moderate fetal ascites and a complex fetal abdominal mass near the small bowel detected by ultrasound at 32 weeks with spontaneous resolution of both ascites and mass by 37 weeks. Following the delivery of a normal neonate, we suspect the mass and ascites to have been produced by a small bowel rupture resulting in meconium peritonitis. Conclusions When fetal ascites with late gestational onset has spontaneous resolution in utero and hydrops never develops, there is generally a favorable prognosis and normal neonatal outcome.

scholarly journals Disseminated Intravascular Coagulopathy following Induced Second Trimester Curettage Abortion

2011 ◽  
Vol 2011 ◽  
pp. 1-2
Author(s):  
Paulami Guha
Keyword(s):  
Recovery Period ◽  
Uneventful Recovery ◽  
Second Trimester ◽  
Trimester Abortion ◽  
Disseminated Intravascular Coagulopathy ◽  
Threatening Condition ◽  
Intravascular Coagulopathy ◽  
Life Threatening ◽  
Second Trimester Abortion ◽  
Packed Rbcs

Background. This is a case of 18-year-old adolescent girl admitted with profuse vaginal bleeding following induced second trimester curettage abortion at 13 weeks of gestation. Case. Her transvaginal sonogram detected retained products of conceptus, and her blood reports revealed a full blown picture of DIC. Dilatation and evacuation was done after initial resuscitation with packed RBCs and platelet concentrates. She had an uneventful recovery period. Conclusion. DIC is an extremely life-threatening condition which can occur as a very infrequent complication of second trimester abortion.

scholarly journals A Case of Midgut Volvulus Associated with a Jejunal Diverticulum

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Joseph Gutowski ◽  
Rachel NeMoyer ◽  
Glenn S. Parker
Keyword(s):  
Abdominal Pain ◽  
Small Bowel ◽  
Internal Hernia ◽  
Midgut Volvulus ◽  
Current Case ◽  
Intermittent Abdominal Pain ◽  
Cat Scan ◽  
Jejunal Diverticulum ◽  
Life Threatening ◽  
Swirl Sign

Midgut volvulus in adults is a rare entity that may present with intermittent colicky abdominal pain mixed with completely asymptomatic episodes. This small bowel twist may result in complications of obstruction, ischemia, hemorrhage, or perforation. With a midgut volvulus, complications may be life-threatening, and emergent surgical intervention is the mainstay of treatment. This current case involves an 80-year-old woman with intermittent abdominal pain with increasing severity and decreasing interval of time to presentation. A CAT scan revealed mesenteric swirling with possible internal hernia. A diagnostic laparoscopy followed by laparotomy revealed a midgut volvulus, extensive adhesions involving the root of the mesentery, and a large jejunal diverticulum. The adhesions were lysed enabling untwisting of the bowel, allowing placement of the small bowel in the correct anatomic position and resection of the jejunal diverticulum. This is a rare case of midgut volvulus with intermittent abdominal pain, associated with jejunal diverticulum managed successfully. A midgut volvulus should be considered in the differential diagnosis of a patient who present with a small bowel obstruction secondary to an internal hernia, especially when a swirl sign is present on the CAT scan.

scholarly journals Intestinal Malrotation with Midgut Volvulus leading to Small Bowel Obstruction in a Young Adult: A Case Report

2020 ◽  
Vol 9 (2) ◽  
pp. 149-152
Author(s):  
Junaid Zia Hashmi ◽  
Talha Kareem ◽  
Masood ur Rauf Khan Hiraj
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Iliac Fossa ◽  
Rare Condition ◽  
Intestinal Malrotation ◽  
Uneventful Recovery ◽  
Midgut Volvulus ◽  
Left Iliac Fossa ◽  
Ladd’S Procedure

The developing intestine rotates around the superior mesenteric vessels during physiological herniation from 6th to 10th weeks of embryogenesis. Intestinal malrotation leading to midgut volvulus and small bowel obstruction is a rare condition. Patients who develop this condition usually present in the first year of their life. Intestinal malrotation is characterized by right sided duodenojejunal junction, caecum in left iliac fossa and a narrow mesentery. Ladd’s procedure is the treatment of choice which is done to restore the normal anatomy. We report the case of an 18-year-old male patient, who presented with intestinal malrotation in emergency department of Nishtar Hospital, Multan. It is an uncommon age for presentation of this anomaly. The patient had fecal peritonitis due to caecal perforation. He underwent Ladd’s procedure in which ileocolostomy was made after right hemicolectomy. The patient had an uneventful recovery after the surgery and had no complaints on follow up visit one week after the discharge.

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