第17巻 2021年10月　第4号

■症例報告

幼児期に腸回転異常症から中腸軸捻転をきたした1例
濱本　光¹, 竹下　輝¹, 佐野　透美¹, 上春　光司¹, 橋本　康司¹, 田嶋　華子¹, 早川　潤¹, 宮尾　昌樹², 高橋　翼², 右田　真^1
1日本医科大学武蔵小杉病院周産期・小児医療センター小児科
²日本医科大学武蔵小杉病院周産期・小児医療センター小児外科

A Case of Midgut Volvulus with Intestinal Malrotation in a 4-year-old Boy
Hikaru Hamamoto¹, Hikaru Takeshita¹, Tohmi Sano¹, Kohji Ueharu¹, Kohji Hashimoto¹, Hanako Tajima¹, Jun Hayakawa¹, Masaki Miyao², Tsubasa Takahashi² and Makoto Migita^1
1)Department of Pediatrics, Nippon Medical School Musashi Kosugi Hospital Perinatal and Pediatric Medical Center
²⁾Department of Pediatric Surgery, Nippon Medical School Musashi Kosugi Hospital Perinatal and Pediatric Medical Center

Malrotation is the incomplete rotation of the intestine during the fetal period. We report a case of midgut volvulus due to intestinal malrotation in a 4-year-boy. The patient was hospitalized for abdominal pain and non-biliary emesis. Biliary emesis was observed on the second day, and intestinal obstruction was suspected. Enhanced abdominal computed tomography showed that the positions of the superior mesenteric artery (SMA) and superior mesenteric vein (SMV) were reversed left and right (SMV rotation sign), with swirling of the SMV around the SMA (whirlpool sign). The diagnosis was midgut volvulus with abnormal intestinal rotation. Emergency Ladd surgery was performed on the same day. Since surgery, the patient has not re-twisted and is in good condition. The majority of such patients are diagnosed within the first year of life with symptoms of biliary emesis and bowel obstruction. Although midgut volvulus is rare in young children, it is necessary to consider the possibility.

日医大医会誌 2021; 17(4), 186-190

Key words
malrotation, midgut volvulus

Correspondence to
Hikaru Hamamoto, Department of Pediatrics, Nippon Medical School Musashi Kosugi Hospital Perinatal and Pediatric Medical Center, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
E-mail： s11-082hh@nms.ac.jp

受付：2021年5月11日　受理：2021年8月2日