Prenatal diagnosis of isolated bowel malrotation and its impact on post-natal management. A case report and review of the literature
Introduction: Intestinal rotation anomalies (IRA) involve a spectrum of congenital defects of bowel rotation and fixation arising in the prenatal period. They may predispose to life-threatening conditions such as severe obstruction or midgut volvulus. We present a case of prenatal diagnosis of isola...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Journal of Pediatric Surgery Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576623000532 |
| _version_ | 1797850430990974976 |
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| author | Andrea Zulli Francesca Tocchioni Chiara Oreglio Roberto Biagiotti Marco Di Maurizio Francesco Morini |
| author_facet | Andrea Zulli Francesca Tocchioni Chiara Oreglio Roberto Biagiotti Marco Di Maurizio Francesco Morini |
| author_sort | Andrea Zulli |
| collection | DOAJ |
| description | Introduction: Intestinal rotation anomalies (IRA) involve a spectrum of congenital defects of bowel rotation and fixation arising in the prenatal period. They may predispose to life-threatening conditions such as severe obstruction or midgut volvulus. We present a case of prenatal diagnosis of isolated IRA and discuss the implications on postnatal management. Case presentation: Inversion of mesenteric vessels and colon misplacement in the left abdomen was found at routine 3rd trimester US in a 30 y.o. healthy woman. Prenatal MRI showed colon in the left and small bowel in the right and central abdomen. Postnatal GI contrast study was compatible with intestinal non-rotation with the cecum high in the left abdomen, which was confirmed at surgery. Post-operative course was uneventful. The patient is in good clinical conditions, thriving well, with no reported problems at follow-up. Conclusions: Abnormal bowel rotation may be detected prenatally also in the absence of US signs of congenital anomalies that are typically associated with IRA or related complications. When intestinal malrotation is suspected, prenatal US and fetal MRI may help guiding postnatal management, eventually allowing prompt surgical management to prevent midgut volvulus. |
| first_indexed | 2024-04-09T19:01:09Z |
| format | Article |
| id | doaj.art-51e1a6cf50624afb91aaef2b9ffa113f |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-04-09T19:01:09Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-51e1a6cf50624afb91aaef2b9ffa113f2023-04-08T05:11:34ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662023-05-0192102627Prenatal diagnosis of isolated bowel malrotation and its impact on post-natal management. A case report and review of the literatureAndrea Zulli0Francesca Tocchioni1Chiara Oreglio2Roberto Biagiotti3Marco Di Maurizio4Francesco Morini5Neurofarba Department, University of Florence, Italy; Department of Pediatric and Neonatal Surgery, Meyer Children's Hospital IRCCS, Florence, Italy; Corresponding author. Neurofarba Department, University of Florence, Florence, Viale G. Pieraccini 24, 50134, Italy.Department of Pediatric and Neonatal Surgery, Meyer Children's Hospital IRCCS, Florence, ItalyNeurofarba Department, University of Florence, Italy; Department of Pediatric and Neonatal Surgery, Meyer Children's Hospital IRCCS, Florence, ItalyPrenatal diagnosis and congenital defects, Meyer Children's Hospital IRCCS, Florence, ItalyDepartment of Radiology, Meyer Children's Hospital IRCCS, Florence, ItalyNeurofarba Department, University of Florence, Italy; Department of Pediatric and Neonatal Surgery, Meyer Children's Hospital IRCCS, Florence, ItalyIntroduction: Intestinal rotation anomalies (IRA) involve a spectrum of congenital defects of bowel rotation and fixation arising in the prenatal period. They may predispose to life-threatening conditions such as severe obstruction or midgut volvulus. We present a case of prenatal diagnosis of isolated IRA and discuss the implications on postnatal management. Case presentation: Inversion of mesenteric vessels and colon misplacement in the left abdomen was found at routine 3rd trimester US in a 30 y.o. healthy woman. Prenatal MRI showed colon in the left and small bowel in the right and central abdomen. Postnatal GI contrast study was compatible with intestinal non-rotation with the cecum high in the left abdomen, which was confirmed at surgery. Post-operative course was uneventful. The patient is in good clinical conditions, thriving well, with no reported problems at follow-up. Conclusions: Abnormal bowel rotation may be detected prenatally also in the absence of US signs of congenital anomalies that are typically associated with IRA or related complications. When intestinal malrotation is suspected, prenatal US and fetal MRI may help guiding postnatal management, eventually allowing prompt surgical management to prevent midgut volvulus.http://www.sciencedirect.com/science/article/pii/S2213576623000532Prenatal diagnosisCase reportBowel malrotationMidgut volvulusLadd procedure |
| spellingShingle | Andrea Zulli Francesca Tocchioni Chiara Oreglio Roberto Biagiotti Marco Di Maurizio Francesco Morini Prenatal diagnosis of isolated bowel malrotation and its impact on post-natal management. A case report and review of the literature Journal of Pediatric Surgery Case Reports Prenatal diagnosis Case report Bowel malrotation Midgut volvulus Ladd procedure |
| title | Prenatal diagnosis of isolated bowel malrotation and its impact on post-natal management. A case report and review of the literature |
| title_full | Prenatal diagnosis of isolated bowel malrotation and its impact on post-natal management. A case report and review of the literature |
| title_fullStr | Prenatal diagnosis of isolated bowel malrotation and its impact on post-natal management. A case report and review of the literature |
| title_full_unstemmed | Prenatal diagnosis of isolated bowel malrotation and its impact on post-natal management. A case report and review of the literature |
| title_short | Prenatal diagnosis of isolated bowel malrotation and its impact on post-natal management. A case report and review of the literature |
| title_sort | prenatal diagnosis of isolated bowel malrotation and its impact on post natal management a case report and review of the literature |
| topic | Prenatal diagnosis Case report Bowel malrotation Midgut volvulus Ladd procedure |
| url | http://www.sciencedirect.com/science/article/pii/S2213576623000532 |
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