Midgut volvulus with complete malrotation in an infant: First case report from Somalia

Abstract

Introduction

Malrotation is a congenital anomaly affecting small and large bowels, with 1 in 500 live births globally. It's often accompanied by bilious vomiting, which may occur with or without abdominal distension. Midgut volvulus is a major complication that can arise from malrotation, presenting a significant risk to life and requiring immediate surgical intervention. This is the first case report of midgut volvulus with complete malrotation in an infant from Somalia.

Case presentation

Our case is a 40-day old term male presented with bilious vomiting and constipation for 5 days. He was resuscitated and underwent Color Doppler ultrasound of the abdomen that showed the whirlpool sign and reversal of superior mesenteric artery and superior mesenteric vein. Following the Ladd's procedure, he was discharged from the hospital, demonstrating effective feeding and the absence of vomiting.

Discussion

Intestinal malrotation, a congenital anomaly affecting approximately 1 in 500 live births, carries a significant risk of midgut volvulus, a life-threatening surgical emergency. This report presents the first documented case of complete intestinal malrotation with midgut volvulus in an infant from Somalia, highlighting the challenges of diagnosis and management in resource-constrained settings. The case highlights the importance of accessible diagnostic tools and prompt surgical intervention.

Conclusion

This case highlights the importance of heightened awareness, sonographic expertise, and skilled surgical management of midgut volvulus with complete malrotation to improve outcomes, particularly in underserved regions where access to advanced pediatric care remains limited.