Background: Small intestinal volvulus often occurs with malrotation. However, in some cases, it could develop without any other clinical conditions, and this is called primary segmental volvulus (PSV) of the small intestine. Two types of PSV (early and late neonatal) have been described previously, especially in preterms. Moreover, there were other cases occurring beyond the neonatal period. Methods: The medical records of 14 cases definitively identified as PSV were retrospectively reviewed. The patients were divided into 2 groups according to postnatal age at diagnosis: neonatal group and beyond neonatal group. Then, the 2 groups were compared in terms of clinical features. Results: There were 11 patients in the neonatal group (78.6%) and 3 patients in the beyond neonatal group (21.4%). There were no differences in gestational age, birth weight, and ratio of prematurity. In the neonatal group, the antenatal abnormal sonographic findings were found more frequently and the perforation of the involved segment were relatively common. Meanwhile, the involved segment was confined to the ileum and more commonly associated with mesentery change in the beyond neonatal group. There was no mortality. Conclusion: The 2 clinical types of PSV according to postnatal age at diagnosis show some differences in clinical features. Moreover, PSV should be considered a possible cause of surgical problems beyond the neonatal period.

Purpose: Alimentary tract duplication (ATD) is a rare congenital condition that may occur throughout the intestinal tract. Clinical symptoms are generally related to the involved site, size of duplication, or associated ectopic mucosa. This study aimed to identify clinical implications by anatomical locations and age group and then suggest a relevant management according to its distinct features. Methods: We retrospectively reviewed the clinical data of pediatric patients who received a surgical management due to ATD. Furthermore, data including patients' demographics, anatomical distribution of the duplication, clinical features according to anatomical variants, and outcomes were compared. Results: A total of 25 patients were included in this study. ATD developed most commonly in the midgut, especially at the ileocecal region. The most common clinical presentation was abdominal pain, a sign resulting from intestinal obstruction, gastrointestinal bleeding, and intussusception. The non-communicating cystic type was the most common pathological feature in all age groups. Clinically, prenatal detection was relatively low; however, it usually manifested before the infantile period. A laparoscopic procedure was performed in most cases (18/25, 72.0%), significantly in the midgut lesion (p=0.012). Conclusion: ATD occurs most commonly at the ileocecal region, and a symptomatic one may usually be detected before the early childhood period. Surgical management should be considered whether symptom or not regarding its symptomatic progression, and a minimal invasive procedure is the preferred method, especially for the midgut lesion.