Intrauterine volvulus without malrotation in a very low-birth-weight preterm infant

Midgut volvulus without abnormalities of intestinal rotation/fixation is an extremely rare cause of acute intestinal obstruction in the neonatal period with a high morbidity and mortality. The authors describe an intrauterine volvulus without malrotation in a 970g preterm girl born at 27 weeks' gestation. The discrepancy between minimally evocatory clinical manifestations and severity of intestinal pathology is underscored. Resection of the necrotic bowel and primary end-to-end anastomosis within 30 hours of birth was followed by a favorable outcome. A literature review indicates a significant relation of intrauterine midgut volvulus without malrotation to preterm birth with low-birth-weight, immediate postnatal presentation and favorable prognosis.