Sentinel bowel loop as a marker for primary segmental intestinal volvulus in extreme low birth weight neonates

Zahouani, T, Carter, W.R, Jessel, R. H, El-Metwally, D.E*, Crowley, H.M. | JNPM 2021;

Abstract: Primary segmental intestinal volvulus is a rare condition that may affect neonates. This condition occurs when a loop of bowel torses around the axis of its mesentery without any other abnormality or malrotation. In the earlier stages, the diagnosis can be challenging due to the lack of specific clinical and radiographic signs. Prompt surgical management is critical as a delay in diagnosis may result in bowel loss or death. We present a series of three cases of extremely low birth weight infants with primary segmental volvulus. A sentinel bowel loop was critical in guiding each patient’s surgical management as there were no other clinical markers concerning a pending intra-abdominal catastrophe. This case series suggests that a sentinel bowel loop may be a radiographic marker for primary segmental intestinal volvulus in extremely low birth weight infants.

*Corresponding Author: 

 Dina El-Metwally, MD, Department of Pediatrics, University of Maryland School of Medicine, 110 South Paca Street, 8th Floor, Baltimore,MD21201, USA. Tel.: +1 410 328 6003; Fax: +1 410 328 1076; E-mail: dmetwally@SOM.umaryland.edu.