CAJ | 학술논문

Fetal midgut volvulus is quite rare,and most cases areassociated with abnormalities of intestinal rotation orfixation.We report a case of midgut volvulus withoutmalrotation,associated with a meconium pellet,duringthe gestation period.This 2.79 kg,33-wk infant was bornvia a spontaneous vaginal delivery caused by pretermlabor.Prenatal ultrasound showed dilated bowel loopswith the appearance of a 'coffee bean sign" This patienthad an unusual presentation with a distended abdomenshowing skin discoloration.An emergency laparotomyrevealed a midgut volvulus and a twisted small bowel,caused by complicated meconium ileus.Such nonspecificprenatal radiological signs and a low index of suspicionof a volvulus during gestation might delay appropriatesurgical management and result in ischemic necrosis of the bowel.Preterm labor,specific prenatal sonographicfindings (for example,the coffee bean sign) and bluishdiscoloration of the abdominal wall could suggestintrauterine midgut volvulus requiring prompt surgicalintervention.