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.


METHODS
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.


CONCLUSIONS
This patient represents a case of midgut volvulus with bowel infarction and necrosis secondary to congenital malrotation of the gut.
Ventura-Braswell
A M
AM
Department of Obstetrics and Gynecology, Wilford Hall Medical Center/Brooke Army Medical Center/Darnall Army Community Hospital, San Antonio, Texas, USA.
Satin
A J
AJ
Higby
K
K
D000328:Adult; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000151:congenital* / Q000175:diagnosis* / Q000209:etiology; D007744:Obstetric Labor Complications / Q000175:diagnosis*; D011247:Pregnancy