1. Predictive factors of bowel resection for midgut volvulus based on an analysis of bi-center experiences in southern Japan.
- Author
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Nagano, Ayaka, Sugita, Koshiro, Harumatsu, Toshio, Nishida, Nanako, Kedoin, Chihiro, Murakami, Masakazu, Yano, Keisuke, Onishi, Shun, Matsukubo, Makoto, Kawano, Takafumi, Muto, Mitsuru, Torikai, Motofumi, Kaji, Tatsuru, and Ieiri, Satoshi
- Abstract
Purpose: Midgut volvulus is an urgent disease often occurring in neonates. This study clarified the clinical features of midgut volvulus and evaluated predictors to avoid bowel resection. Methods: This bi-center retrospective study enrolled 48 patients who underwent surgery for intestinal malrotation between 2010 and 2022. Patients’ background characteristics and preoperative imaging findings were reviewed. Results: Midgut volvulus was recognized in 32 patients (66.7%), and 6 (12.5%) underwent bowel resection. Based on a receiver operating curve analysis of bowel resection, the cut-off value of the body weight at birth and at operation were 1984 g [area under the curve (AUC) 0.75, 95% confidence interval (CI) 0.52–0.99] and 2418 g (AUC 0.70, 95% CI 0.46–0.94), respectively. The cut-off value of intestinal torsion was 540° (AUC 0.76, 95% CI 0.57–0.95), and that of the time from the onset to the diagnosis was 12 h (AUC 0.85, 95% CI 0.72–0.98). For midgut volvulus with an intestinal torsion > 540°, the most sensitive preoperative imaging test was ultrasonography (75%) Patients with bloody stool tended to undergo bowel resection. Conclusions: Patients with a low body weight and bloody stool should be confirmed to have whirlpool sign by ultrasonography and scheduled for surgery as soon as possible. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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