Intrauterine midgut volvulus without malrotation: Diagnosis from the 'coffee bean sign'

被引:37
作者
Park, Jun Seok [1 ]
Cha, Seong Jae [1 ]
Kim, Beom Gyu [1 ]
Kim, Yong Seok [1 ]
Choi, Yoo Shin [1 ]
Chang, In Taik [1 ]
Kim, Gwang Jun [2 ]
Lee, Woo Seok [2 ]
Kim, Gi Hyeon [2 ,3 ]
机构
[1] Chung Ang Univ, Coll Med, Dept Surg, Seoul 156755, South Korea
[2] Chung Ang Univ, Coll Med, Dept Obstet & Gynecol, Seoul 156755, South Korea
[3] Chung Ang Univ, Coll Med, Dept Radiol, Seoul 156755, South Korea
关键词
midgut volvulus; coffee bean sign; meconium ileus;
D O I
10.3748/wjg.14.1456
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Fetal midgut volvulus is quite rare, and most cases are associated with abnormalities of intestinal rotation or fixation. We report a case of midgut volvulus without malrotation, associated with a meconium pellet, during the gestation period. This 2.79 kg, 33-wk infant was born via a spontaneous vaginal delivery caused by preterm labor. Prenatal ultrasound showed dilated bowel loops with the appearance of a 'coffee bean sign' This patient had an unusual presentation with a distended abdomen showing skin discoloration. An emergency laparotomy revealed a midgut volvulus and a twisted small bowel, caused by complicated meconium ileus. Such nonspecific prenatal radiological signs and a low index of suspicion of a volvulus during gestation might delay appropriate surgical management and result in ischemic necrosis of the bowel. Preterm labor, specific prenatal sonographic findings (for example, the coffee bean sign) and bluish discoloration of the abdominal wall could suggest intrauterine midgut volvulus requiring prompt surgical intervention. (c) 2008 WJG. All rights reserved.
引用
收藏
页码:1456 / 1458
页数:3
相关论文
共 15 条
[1]  
ANDRASSY RJ, 1981, ARCH SURG-CHICAGO, V116, P158
[2]   ANTEPARTUM DIAGNOSIS AND MANAGEMENT OF INUTERO INTESTINAL VOLVULUS WITH PERFORATION [J].
BAXI, LV ;
YEH, MN ;
BLANC, WA ;
SCHULLINGER, JN .
NEW ENGLAND JOURNAL OF MEDICINE, 1983, 308 (25) :1519-1521
[3]   MESENTERIC DEFECTS AS A CAUSE OF INTESTINAL VOLVULUS WITHOUT MALROTATION AND AS THE POSSIBLE PRIMARY ETIOLOGY OF INTESTINAL ATRESIA [J].
BLACK, PR ;
MUELLER, D ;
CROW, J ;
MORRIS, RC ;
HUSAIN, AN .
JOURNAL OF PEDIATRIC SURGERY, 1994, 29 (10) :1339-1343
[4]   Dorsal mesenteric agenesis without small bowel atresia: a rare cause of midgut volvulus in children [J].
Cascio, Salvatore ;
Tien, Alan Sze Loong ;
Agarwal, Prakash ;
Tan, Hock Lim .
JOURNAL OF PEDIATRIC SURGERY, 2006, 41 (09) :e5-e7
[5]   Fetal midgut volvulus presenting at term [J].
Crisera, CA ;
Ginsburg, HB ;
Gitres, GK .
JOURNAL OF PEDIATRIC SURGERY, 1999, 34 (08) :1280-1281
[6]  
DeFelice C, 1997, ACTA OBSTET GYN SCAN, V76, P386
[7]   A PLACENTAL CLOCK CONTROLLING THE LENGTH OF HUMAN-PREGNANCY [J].
MCLEAN, M ;
BISITS, A ;
DAVIES, J ;
WOODS, R ;
LOWRY, P ;
SMITH, R .
NATURE MEDICINE, 1995, 1 (05) :460-463
[8]   PRENATAL-DIAGNOSIS AND MANAGEMENT OF CONGENITAL VOLVULUS [J].
MERCADO, MG ;
BULAS, DI ;
CHANDRA, R .
PEDIATRIC RADIOLOGY, 1993, 23 (08) :601-602
[9]   Intrauterine intestinal obstruction due to fetal midgut volvulus:: A report of two cases [J].
Molvarec, Attila ;
Babinszki, Agota ;
Kovacs, Kalman ;
Toth, Ferenc ;
Szalay, Janos .
FETAL DIAGNOSIS AND THERAPY, 2007, 22 (01) :38-40
[10]   Intrauterine volvulus without malrotation associated with segmental absence of small intestinal musculature [J].
Morikawa, N ;
Namba, S ;
Fujii, Y ;
Sato, Y ;
Fukuba, K .
JOURNAL OF PEDIATRIC SURGERY, 1999, 34 (10) :1549-1551