• Henry Chong Lee, Sarah S Pickard, Sunita Sridhar, and Sanjeev Dutta.
• Department of Pediatrics, Division of Neonatology, University of California, San Francisco, San Francisco, California, USA.
• J Emerg Med. 2012 Jul 1;43(1):e49-51.

BackgroundIntestinal malrotation in the newborn is usually diagnosed after signs of intestinal obstruction, such as bilious emesis, and corrected with the Ladd procedure.ObjectivesThe objective of this report is to describe the presentation of severe cases of midgut volvulus presenting in infancy, and to discuss the characteristics of these cases.Case ReportWe performed a 7-year review at our institution and present two cases of catastrophic midgut volvulus presenting in the post-neonatal period, ending in death soon after the onset of symptoms. These two patients also had significant laboratory abnormalities compared to patients with more typical presentations resulting in favorable outcomes.ConclusionsAlthough most cases of intestinal malrotation in infancy can be treated successfully, in some circumstances, patients' symptoms may not be detected early enough for effective treatment, and therefore may result in catastrophic midgut volvulus and death.Copyright © 2012 Elsevier Inc. All rights reserved.

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