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Updated: Aug 6, 2026
06:27
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Volvulus in preterm neonates: An overlooked diagnosis
Ahmed Refaat Khodary1, Hemanshoo Thakkar1, Iain Yardley1
1Evelina London Children Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Journal of Pediatric Surgery
|July 18, 2026
Summary
Diagnosing intestinal volvulus in preterm infants is challenging, often mistaken for necrotizing enterocolitis (NEC). This leads to delayed surgery and worse outcomes compared to full-term infants.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Surgical outcomes
Background:
- Intestinal volvulus is a critical surgical emergency in neonates.
- Early diagnosis and intervention are key to reducing mortality and morbidity.
- Diagnosing volvulus in preterm infants presents unique challenges.
Purpose of the Study:
- To compare the presentation, diagnosis, surgical management, and outcomes of intestinal volvulus in preterm versus full-term infants.
- To identify factors contributing to diagnostic delays in preterm neonates.
- To evaluate the impact of prematurity on surgical outcomes for intestinal volvulus.
Main Methods:
- Retrospective review of neonatal patients with confirmed intestinal volvulus (October 2023 - September 2025).
- Patients divided into preterm (<37 weeks) and full-term (≥37 weeks) groups.
- Comparison of demographics, presentation, time to surgery, and postoperative course.
Main Results:
- Preterm infants were less likely to show bilious vomiting and more likely to have abdominal distension and generalized deterioration.
- Necrotizing enterocolitis (NEC) was the initial clinical impression in many preterm infants.
- Preterm infants had longer surgical delays, higher intestinal resection rates, and significantly more postoperative complications, longer feeding times, and longer hospital stays.
Conclusions:
- Atypical presentations in preterm infants frequently lead to misdiagnosis as NEC.
- Diagnostic challenges result in delayed surgical intervention for volvulus in preterm neonates.
- Volvulus in preterm infants is associated with substantially higher morbidity and mortality than in term infants.
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