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Distinguishing outcomes of neonatal intestinal volvulus: Review of our experience over the last 20 years
Author(s) -
MayaEnero Silvia,
PratOrtells Jordi,
MartínSolé Oriol,
De HaroJorge Irene,
PertierraCortada Àfrica,
IriondoSanz Martín
Publication year - 2022
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.16167
Subject(s) - medicine , volvulus , gastroenterology , logistic regression , cystic fibrosis , retrospective cohort study , pediatrics
Aim There are two types of intestinal volvulus: midgut (MGV) and segmental (SV). Patients with different types of intestinal volvulus are often included in the same case series, which may affect the perception of how severe "intestinal volvuli" are. We aimed to compare both types of intestinal volvulus. Methods This is a retrospective observational study including all patients with MGV and SV up to 28 days of life admitted to a tertiary hospital in Spain over a 20‐year‐period (1999–2019). A comparison between groups and a logistic regression model for mortality were done. Results We identified 32 patients: 23 MGV and 9 SV. Malrotation was exclusive of MGV. Prenatal diagnosis, cystic fibrosis, and intestinal resection were significantly more frequent in SV. Surgery was performed at a significantly lower age in SV. The mortality observed in acute MGV with intestinal compromise (41.7%) is four times higher than the mortality of SV (11.1%). The overall mortality of all MGV patients (21.7%) is almost twice that of SV. Mortality was best predicted by the presence of hemodynamic instability (OR 27.5 95% CI 2.50–302.17; p = 0.007). Conclusion SV and MGV have a different clinical presentation. Hemodynamic instability is the major risk factor for death.