Duplication cyst with midgut volvulus in a neonate: an unusual presentation

Incomplete intestinal fixation or malrotation of gut with midgut volvulus is one of the important causes of bilious vomiting in neonates. The incidence of malrotation of gut in population is 4% and that of duplication cyst is 1:4500. Patients with malrotation are prone to develop midgut volvulus due...

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Bibliographic Details
Published in:BMJ case reports 2020-08, Vol.13 (8), p.e235526
Main Authors: Pai, Nitin G, Prabhu, Santosh, Prabhakar, Pavithra, Kumar, Vijay
Format: Article
Language:English
Subjects:
Abdomen
Case reports
congenital disorders
Cysts
Cysts - complications
Cysts - congenital
Cysts - diagnosis
Cysts - surgery
Female
Histopathology
Humans
Infant, Newborn
Intestinal Diseases - complications
Intestinal Diseases - congenital
Intestinal Diseases - diagnosis
Intestinal Diseases - surgery
Intestinal obstruction
Intestinal Volvulus - complications
Intestinal Volvulus - diagnosis
Intestinal Volvulus - surgery
Laparotomy
neonatal and paediatric intensive care
neonatal health
Newborn babies
paediatric surgery
pathology
Pediatrics
Rare Disease
Ultrasonic imaging
Vomiting
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Summary:Incomplete intestinal fixation or malrotation of gut with midgut volvulus is one of the important causes of bilious vomiting in neonates. The incidence of malrotation of gut in population is 4% and that of duplication cyst is 1:4500. Patients with malrotation are prone to develop midgut volvulus due to their narrow mesenteric base demanding urgent surgical intervention. Common associated anomalies are intrinsic duodenal obstruction, internal hernias, caecal volvulus, anorectal malformations and Hirschsprung’s disease. The present case refers to a 4-day-old neonate who presented with malrotation of gut with reverse volvulus and an associated gastrointestinal duplication cyst, which is a rare association with only few reported case reports. After imaging with ultrasound and contrast radiograph, the baby underwent prompt surgical intervention in the form of Ladd’s procedure with resection and anastomosis of jejunal duplication cyst.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2020-235526