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A fatal twist in childhood: A post-mortem finding of intestinal volvulus with malrotation

R Z Tan1, F L Darwin, K Anuar Zainun

  • 1Hospital Sungai Buloh, Department of Forensic Medicine, Sungai Buloh, Selangor, Malaysia. ranzhi_85@yahoo.com.

The Malaysian Journal of Pathology
|December 28, 2020
PubMed

Insights

Gastrointestinal pathology is rare in children but can be fatal. This case highlights how intestinal volvulus, exacerbated by bronchopneumonia and sepsis, led to death in a 3-year-old girl with intestinal malrotation.

Area of Science:

  • Pediatric Pathology
  • Gastrointestinal Surgery
  • Medical Case Reports

Background:

  • Gastrointestinal pathology causing death in children is infrequent, with common causes including intestinal obstruction, peritonitis, and bleeding.
  • Prompt medical attention typically leads to appropriate treatment for severe pediatric gastrointestinal conditions.
  • However, certain pathologies can progress rapidly and prove fatal, especially with contributing factors.

Observation:

  • A rare case of intestinal volvulus in a 3-year-old girl is presented.
  • The child experienced a brief history of vomiting prior to death.
  • Contributing factors identified post-mortem included bronchopneumonia, sepsis, and underlying intestinal malrotation.

Findings:

  • Intestinal volvulus, though uncommon, can be a cause of mortality in pediatric patients.
  • Bronchopneumonia and sepsis can act as critical co-factors in the rapid progression of gastrointestinal emergencies.
  • Undiagnosed intestinal malrotation significantly increases the risk of volvulus.

Implications:

  • This case underscores the importance of considering rare gastrointestinal emergencies in pediatric differential diagnoses.
  • Early recognition and management of intestinal malrotation are crucial to prevent life-threatening complications like volvulus.
  • The interplay of infection (bronchopneumonia, sepsis) and congenital anomalies (intestinal malrotation) can precipitate fatal outcomes in children.

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