Obstructive jaundice secondary to chronic midgut volvulus.

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Congenital Anomalies

Background:

• Intestinal malrotation is a congenital anomaly that can lead to midgut volvulus, a surgical emergency.
• Midgut volvulus can cause complications such as bowel ischemia and obstruction.
• Biliary obstruction is an uncommon but serious complication of midgut volvulus.

Observation:

• A 5-month-old female infant presented with progressive extrahepatic biliary obstruction.
• Imaging and clinical evaluation revealed chronic midgut volvulus secondary to intestinal malrotation.
• The patient exhibited signs and symptoms consistent with significant bile duct compromise.

Findings:

• Surgical exploration confirmed intestinal malrotation and identified obstructing bands.
• Correction of the malrotation and division of the obstructing bands were performed.
• Postoperatively, the biliary obstruction resolved, with normalization of bile flow.

Implications:

• This case highlights the potential for midgut volvulus to cause severe biliary obstruction in infants.
• Early diagnosis and surgical intervention are crucial for favorable outcomes.
• Management of intestinal malrotation can effectively relieve secondary biliary complications.