Intrauterine volvulus that had been misunderstood as an antenatal mesenteric cyst

Gültekin, Nazlı Dilay; Salihoğlu, Özgül; Alptekin, Ahmet; Yılmaz, Fatma Hilal; Altunhan, Hüseyin

doi:10.1016/j.pedneo.2018.08.009

Cited by 3 publications

(13 citation statements)

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“…Three (3.4%) foetuses 29,43,52 underwent prenatal paracentesis for foetal ascites, and 1 (1.1%) 27 underwent diagnostic cordocentesis. Following delivery, 71 (80.7%) cases 2–4,6–9,12–15,17–22,24–27,29–31,33–35,42–49,51–54,56–61,63–66 had recorded timeframes for treatment of volvulus. Fifty‐three (53/71, 74.6%) of these infants 2,4–8,14–17,19–21,24–26,30,31,33–35,42–47,49,51,52,54–59,63 were treated immediately after birth or within 24 h of age.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, 68/71 (95.8%) infants underwent postnatal surgery within 72 h. The remaining three cases 27,53,60 were treated by day 10, day 39 and 7 months of life (spontaneous volvulus secondary to undiagnosed malrotation). Out of a total of 79 surgically treated neonates, stoma creation with secondary anastomosis was undertaken in 25 (31.6%) cases 2,5,12–14,19,20,29,31,42,46,47,49,51,54,56,57,66 . Fifteen neonates (15/79, 19.0%) 5,8,14,27,29,47,50,54,57,65–67 required additional surgery for bowel obstruction, perforated ileus and stoma failure.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 83 (94.3%) cases 2–9,11–22,24–27,29–35,42–54,56–61,63–67 where pregnancy outcome data was available, four (4.8%) 4,61 underwent termination of pregnancy (TOP), one (1.2%) 32 was stillborn, seven (8.4%) were neonatal deaths, 4,18,21,47,50 and four (4.8%) 19,54,57,67 were deaths outside of the neonatal period. Causes of death were not universally reported, but included multi‐organ failure, sepsis, complications from CF and short bowel syndrome.…”

Section: Resultsmentioning

confidence: 99%

“…There are also associations with cystic fibrosis (CF), mesenteric defects, delayed return of midgut to the abdomen, intestinal agenesis or atresia and abdominal muscle wall defects 3–12 . Early surgical intervention and delivery planning is crucial to reducing perinatal morbidity and mortality 3,13,14 . Prognostic determinants of outcome include length of viable bowel, birth weight, gestational age, presence of meconium peritonitis, oligohydramnios or other neonatal co‐morbidities 15–20 …”

Section: Introductionmentioning

confidence: 99%

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Prenatal imaging features and perinatal outcomes of foetal volvulus–A literature review

et al. 2022

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Objective To conduct a review of the literature on foetal volvulus with emphasis on prenatal imaging, pregnancy characteristics and clinical outcomes. Methods A review of all published cases of foetal volvulus diagnosed prenatally and indexed in Medline, EBSCOhost, CINAHL, SOCIndex and Healthy Policy Reference Centre. Studies without antenatal sonographic signs of foetal volvulus and without a postpartum surgical diagnosis were excluded. Data were analysed for frequencies and distributions and tested for statistical significance. Results Eighty‐eight cases of foetal volvulus were identified from 58 published case reports/series. The most common ultrasound findings were dilated bowel/stomach (77.3%), polyhydramnios (30.7%) and whirlpool/snail sign (28.4%). Median gestation at diagnosis was 31.9 weeks (IQR 27–34) and mean gestation at delivery was 34.5 weeks (SD 2.8). Underlying aetiology included intestinal malrotation (15.9%), cystic fibrosis (14.8% of all cases, 32.5% of tested cases) and abnormal mesenteric fixation (12.5%). Complications included intestinal atresia (36.4%) and foetal anaemia (9.1%). The overall perinatal mortality rate was 14.5%. Conclusion Foetal volvulus is a rare condition with high rates of preterm birth and perinatal mortality. Intestinal malrotation and cystic fibrosis are common predisposing causes, although the majority are idiopathic. Bowel and/or gastric dilatation is by far the most common sonographic finding.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prenatal imaging features and perinatal outcomes of foetal volvulus–A literature review

et al. 2022

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“…1 However, the initial presentations may be protean, and diagnosing volvulus in neonates is still a challenge. 2 The characteristic whirlpool sign observed in the image, indicating the twisting of the mesentery and superior mesenteric artery and vein, is a diagnostic feature of volvulus. 3 Usually, the whirlpool sign is detected using computed tomography, and an emergent surgical correction is initiated.…”

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confidence: 98%

Sonographic whirlpool sign in neonatal intestinal volvulus

Cheng

Duh

Lin

et al. 2020

Pediatrics & Neonatology

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A full-term male newborn presented with projectile bilious vomiting 4 days after birth. A physical examination revealed a mild abdominal distension without an obvious peritoneal sign. An abdominal X-ray revealed a mild stomach distension and bowel dilatation over the left lower quadrant area (Supplementary Fig. 1). Laboratory tests revealed nonspecific findings, and a transabdominal sonogram revealed a typical whirlpool sign in the epigastric region, indicating the twisting of the mesentery and superior mesenteric artery and vein (Fig. 1, Video). The patient was diagnosed with malrotation and volvulus, and an emergent operation was immediately performed without computed tomography. Furthermore, a malrotation of 360 e540 with midgut volvulus was observed, and the laparoscopic Ladd procedure was smoothly performed without the resection of the intestine. The newborn started feeding on postoperative day

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Intrauterine volvulus: systemic review of the literature with pooled analysis

Acer-Demir,

Şahin-Uysal

2024

J Perinatol

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Our objective is to analyse the observations related to intrauterine volvulus and assess how clinical manifestations and treatment strategies impact prognosis. We conducted a comprehensive search on Pubmed and ClinicalTrials.gov from inception to July 2022, using search terms like “intrauterine volvulus” or “foetal volvulus,” supplemented by manual scrutiny of reference lists in relevant texts and articles. Our review encompassed 57 case reports/case series, involving 88 cases. The presence of foetal bradycardia during prenatal visits (p = 0.002) and the existence of meconium cyst or pseudocyst (p = 0.038) significantly influence survival rates. Preterm labour occurred more frequently among cases resulting in mortality (54% vs 21%; p = 0.055). Our study’s limitations include the inability to access all reported cases and reliance solely on available data. We advocate for vigilant monitoring of foetuses exhibiting signs of intestinal obstruction, and consideration of an emergent caesarean section as a pre-emptive measure before foetal biophysical profile deterioration worsens.

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Intrauterine volvulus that had been misunderstood as an antenatal mesenteric cyst

Cited by 3 publications

References 1 publication

Prenatal imaging features and perinatal outcomes of foetal volvulus–A literature review

Prenatal imaging features and perinatal outcomes of foetal volvulus–A literature review

Sonographic whirlpool sign in neonatal intestinal volvulus

Intrauterine volvulus: systemic review of the literature with pooled analysis

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