Journal article
Manufactured volvulus.
- Zweifel N Division of Visceral, Neonatal, and Fetal Surgery, Department of Pediatric Surgery, Children's University Hospital, Zurich, Switzerland. Noemi.Zweifel@kispi.uzh.ch
- Meuli M
- Subotic U
- Moehrlen U
- Mazzone L
- Arlettaz R
- 2012-11-23
Published in:
- European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie. - 2013
Abdomen
Anastomosis, Surgical
Diagnosis, Differential
Female
Follow-Up Studies
Humans
Infant
Infant, Newborn
Intestinal Volvulus
Intestine, Small
Male
Massage
Radiography, Abdominal
Retrospective Studies
Time Factors
English
BACKGROUND/PURPOSE
Malrotation with a common mesentery is the classical pathology allowing midgut volvulus to occur. There are only a few reports of small bowel volvulus without malrotation or other pathology triggering volvulation. We describe three cases of small bowel volvulus in very premature newborns with a perfectly normal intra-abdominal anatomy and focus on the question, what might have set off volvulation.
METHODS
In 2005 to 2008, three patients developed small bowel volvulus without any underlying pathology. Retrospective patient chart review was performed with special focus on clinical presentation, preoperative management, intraoperative findings, and potential causative explanations. Mean follow-up period was 46 months.
RESULTS
All patients were born between 27 and 31 weeks (mean 28 weeks) with a birth weight between 800 and 1,000 g (mean 887 g). They presented with an almost identical pattern of symptoms including sudden abdominal distension, abdominal tenderness, erythema of the abdominal wall, high gastric residuals, and radiographic signs of ileus. All of them were treated with intensive abdominal massage or pelvic rotation to improve bowel movement before becoming symptomatic.
CONCLUSIONS
Properistaltic maneuvers including abdominal massage and pelvic rotation may cause what we term a "manufactured" volvulus in very premature newborns. Thus, this practice was stopped.
Malrotation with a common mesentery is the classical pathology allowing midgut volvulus to occur. There are only a few reports of small bowel volvulus without malrotation or other pathology triggering volvulation. We describe three cases of small bowel volvulus in very premature newborns with a perfectly normal intra-abdominal anatomy and focus on the question, what might have set off volvulation.
METHODS
In 2005 to 2008, three patients developed small bowel volvulus without any underlying pathology. Retrospective patient chart review was performed with special focus on clinical presentation, preoperative management, intraoperative findings, and potential causative explanations. Mean follow-up period was 46 months.
RESULTS
All patients were born between 27 and 31 weeks (mean 28 weeks) with a birth weight between 800 and 1,000 g (mean 887 g). They presented with an almost identical pattern of symptoms including sudden abdominal distension, abdominal tenderness, erythema of the abdominal wall, high gastric residuals, and radiographic signs of ileus. All of them were treated with intensive abdominal massage or pelvic rotation to improve bowel movement before becoming symptomatic.
CONCLUSIONS
Properistaltic maneuvers including abdominal massage and pelvic rotation may cause what we term a "manufactured" volvulus in very premature newborns. Thus, this practice was stopped.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1055/s-0032-1330843
- PMID 23172568
- Persistent URL
- https://folia.unifr.ch/global/documents/75882
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