Full-thickness small intestine necrosis with midgut volvulus, distributed in a patchy fashion, is reversible with moderate blood flow: resumption of normal function to non-viable intestine.
Midgut volvulus is a highly life-threatening condition that carries a high risk of short gut syndrome. We report a case of catastrophic neonatal midgut volvulus in which second-look laparotomy revealed apparently non-viable remnant small intestine but with a moderate blood supply. Full-thickness small intestine necrosis was distributed in a patchy fashion, with non-viable and necrotic areas distributed so widely that no portion of the intestine could be resected. A section of full-thickness necrotic intestine preserved at surgery was able to regenerate, and normal function was restored over a period of 1 month. This case indicated that intestinal resumption may be dependent on blood flow. Even when intestinal viability is questionable, preservation enables the chance of regeneration if moderate blood flow is present.
Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.
Hizuru
H
Amano
Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Hiroo
H
Uchida
Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.
Hiroshi
H
Kawashima
Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.
Yujiro
Y
Tanaka
Department of Pathology, Saitama Children's Medical Center, Saitama, Japan.
Hiroshi
H
Kishimoto
midgut volvulus; necrosis; neonate; second look operation; viability