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Primary intestinal volvulus in a fetus without an underlying cause has been rarely reported. We report a case of fetal primary segmental volvulus of the ileum. A 27-year-old woman was referred at 32 weeks of gestation for evaluation of decreased fetal movement. A fetal ultrasound detected a single, significantly-dilated bowel loop without a vascular supply (coffee bean sign), and a fetal MRI revealed the ‘whirl-pool sign’. An emergency cesarean delivery and laparotomy revealed segmental volvulus of the ileum without any causative factors. Segmental resection resolved the condition without sequelae. Fetal primary segmental volvulus can occur without any underlying pathology, and rapid diagnosis and prompt intervention is mandatory for a good outcome. [ABSTRACT FROM AUTHOR]

Abstract: Ingestion of multiple magnets poses a particular risk for various intraabdominal complications in children. We herein report a case of ingestion of multiple magnets, of which 3 were spontaneously expelled, and the remaining magnets were surgically removed. Since the total amount of ingestion was unknown upon presentation and the remaining intraabdominal magnets failed to pass after 24 h, emergency surgery was performed. Two magnets sandwiched the bowel walls and formed a jejunoileal fistula. There was no peritoneal contamination. We found that not all the ingested multiple magnets attracted each other, and multiple magnets could appear as single material on a plain radiograph. Confirming the exact count of ingested magnets is important; if the count is in doubt or two or more attachments are evident, prompt surgical intervention is warranted. [Copyright &y& Elsevier]

Abnormalities of the intra-abdominal umbilical venous connections are rare congenital vascular anomalies. We report a case of an aneurismal dilatation of an umbilical vein directly connected to the portal vein, vital for the delivery of placental blood in the fetus. A term female newborn presented with a dilated umbilical vein detected by prenatal ultrasound. CT angiography revealed an aneurismal dilatation of a vascular structure, from the umbilical ring to the main portal vein. Follow-up CT angiography showed thrombus progression up to the level of SMV inlet. A laparotomy revealed that the normal course of the umbilical vein was absent. The aneurysm was resected and no thrombus was noted in the aneurysm. Post-operative ultrasound revealed an isolated thrombus at the right main portal vein that resolved spontaneously on the follow-up ultrasound. At the 6-month post-operative follow-up, the baby was well and without complications. Although not evaluated for the presence of a ductus venosus, this anomalous umbilical-portal venous connection might have been associated with an absent ductus venosus. [ABSTRACT FROM AUTHOR]

Abstract: Massive bleeding from the porta hepatis is a rare complication after a Kasai portoenterostomy and usually requires urgent surgical intervention. Among the causes of the porta hepatis bleeding, bleeding from the injured caudate arterial branches has never been reported. Here, we describe 2 cases of caudate arterial branch bleeding after a Kasai portoenterostomy, which were successfully treated with transcatheter arterial embolization without laparotomy. [Copyright &y& Elsevier]