Second-Look Surgery for Intestinal Salvage in a Neonate With Midgut Volvulus and Intestinal Malrotation: A Case...

Intestinal malrotation is described as an abnormal positioning of intestinal loops within the peritoneal cavity, caused by defective rotation around the superior mesenteric artery. This results in a short mesenteric root, which predisposes to midgut volvulus when the intestine twists on its axis. We present a case of a five-day-old female with bilious vomiting, abdominal distension, and radiographic signs of obstruction. Surgical intervention was decided, revealing midgut volvulus associated with intestinal malrotation and questionable intestinal viability. A second-look surgery was scheduled at 48 hours, during which the Ladd procedure was completed without requiring intestinal resection. In conclusion, we emphasize the importance of early surgical intervention and the use of techniques that may prevent irreversible intestinal necrosis and the need for extensive resections.