Intrauterine volvulus without malrotation associated with segmental absence of small intestinal musculature

A case of intrauterine intestinal volvulus without malrotation is presented, and 9 other cases from the world literature are reviewed. Bloody diarrhea, bluish discoloration of the abdominal wall (Cullen's sign), and a tense abdomen in neonates suggest midgut volvulus requiring prompt surgical management. On pathological examination, the neck of the twisted bowel in this case showed a half-circle defect of the intestinal muscle. This suggests that a segmental defect of the intestinal musculature could be secondary to volvulus. J Pediatr Surg 34:1549-1551. Copyright (C) 1999 by W.B. Saunders Company.