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Late-onset volvulus without malrotation in preterm infants.
Melanie Drewett1, David M Burge
1Neonatal Surgical Service, Department of Neonatal Medicine and Surgery, Princess Anne Hospital, Southampton, United Kingdom.
Journal of Pediatric Surgery
|February 24, 2009
Summary
Late-onset volvulus without malrotation (VWM) in preterm infants presents in two distinct groups: early-onset and a newly identified late-onset group. The late-onset VWM group shows specific symptoms and requires surgical intervention.
Area of Science:
- Pediatric Surgery
- Neonatology
- Gastrointestinal Motility Disorders
Background:
- Volvulus without malrotation (VWM) is a rare condition in infants.
- Understanding VWM presentation is crucial for timely diagnosis and management.
Purpose of the Study:
- To describe a novel observation of late-onset VWM in preterm infants.
- To differentiate clinical presentations of VWM.
Main Methods:
- Retrospective review of medical records for infants diagnosed with VWM.
- Analysis of patient demographics, clinical presentation, and surgical outcomes.
Main Results:
- Ten preterm infants with VWM were identified between 1996 and 2007.
- Two clinical groups emerged: early-onset (within days of birth) and late-onset (after the first month).
- Late-onset VWM patients exhibited recurrent abdominal distension, bile vomiting, and required CPAP, with sudden deterioration necessitating surgery.
Conclusions:
- Two distinct clinical patterns of VWM exist in preterm infants.
- A previously undescribed late-onset VWM group presents with specific clinical features.
- Early recognition of these patterns is vital for effective pediatric surgical intervention.
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