2003-05-19-14 Malrotation of the gut © Serrano www.thefetus.net/
Malrotation of the gut
Meyer Serrano MD
A 28-year old patient was referred for sonography in her 36th week pregnancy, due to increased uterine height. An ultrasound in the first trimester had been reported as "normal".
The sonography showed polyhydrammnios and congenital volvulus.
Figure 1: Corresponds to upper abdomen. The stomach contains echogenic material and adhesions to the abdomen’s wall and ascites
Figure 2: Corresponds to meso-abdomen and can be seen the ecogenic intestine, in the middle of dilated intestinal loop
Figure 3: Corresponds to lower abdomen showing dilated intestinal loop, with volvulus, ecogenic and thickened walls and light ascites
Normal delivery occurred three days after sonography. The new born female, weight 2800 gm, apgar 6/10, 10/10. Surgery was performed 24 hours after delivery.
Surgical findings included:
1. Complete malrotation of the gut.
2. Midgut volvulus with necrosis.
3. Intestinal atresic segment with multiple perforations.
4. Meconium peritonitis.