Malrotation volvulus in a neonate: a novel surgical approach.
A newborn presented with bilious vomiting secondary to a malrotation and presumed perinatal-onset volvulus. Laparotomy was performed at 20 h of age at which the volvulus was derotated. Nevertheless the small but not the large bowel appeared to be completely ischaemic and non-viable. A second-look laparotomy was performed 24 h later with no significant improvement. In a new approach to the problem, nothing further was done and the child was left alone on parenteral nutrition and naso-gastric aspiration for 11 weeks. Further exploration showed that 40 cm of small bowel had survived intact and restorative surgery was carried out. Parenteral nutrition was discontinued after 9 months and the child, now aged 3.5 years, is thriving.
Houben
C H
CH
Department of Paediatric Surgery, St George's Hospital, Blackshaw Road, London, SW, UK. chouben@web.de
Mitton
S
S
Capps
S
S
D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery*; D045822:Intestinal Volvulus / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D007441:Intubation, Gastrointestinal / Q000379:methods; D010288:Parenteral Nutrition / Q000379:methods; D014839:Vomiting / Q000209:etiology