Fatal midgut volvulus: a rare cause of gestational intestinal obstruction.
Malrotation is a congenital abnormality of the gastrointestinal tract that predisposes to midgut volvulus and can lead to small bowel infarction. Midgut volvulus is rare in adulthood and even rarer during pregnancy. If not diagnosed accurately, it carries a high-mortality rate. We present a case of 27-year-old woman with 33 weeks of gestation, who presented with acute abdomen and intrauterine fetal demise. CT angiogram with multidetector row scanner showed the midgut volvulus clearly and unequivocally. Unfortunately, the patient died of septicemia and extensive bowel infarction. CT angiogram images are presented here. To our knowledge, no similar case with gestational midgut volvulus and CT angiogram has been reported previously in the literature.
Apple Hospitals and Research Institute Ltd, Shahupuri, Kolhapur, India. anandsg@doctor.com
Anand
A
Gaikwad
Dhananjay
D
Ghongade
Prashant
P
Kittad
D000006:Abdomen, Acute / Q000209:etiology; D000328:Adult; D000792:Angiography / Q000379:methods; D017809:Fatal Outcome; D005260:Female; D005313:Fetal Death; D006801:Humans; D045822:Intestinal Volvulus / Q000000981:diagnostic imaging*; D017538:Mesenteric Artery, Superior / Q000000981:diagnostic imaging; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D012772:Shock, Septic / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016216:Ultrasonography, Prenatal