{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T05:42:42Z","timestamp":1793684562201,"version":"4.5.1"},"reference-count":17,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,7,3]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>Congenital intestinal malrotation occurs in 1 of 500 newborns and can predispose patients to intestinal volvulus and internal herniation, putting patients at risk for intestinal ischaemia. A male patient in early childhood with a history of severe constipation presented with acute abdominal pain, progressing rapidly to compensated shock. CT scan was suspicious for small bowel ischaemia and superior mesenteric artery compression. He underwent emergency exploratory laparotomy. Intraoperative findings were significant for partial intestinal malrotation with mobile ascending colon and high-riding caecum, and internal herniation with midgut volvulus of the ascending colon through a mesenteric defect in the proximal transverse colon. Derotation of the volvulus, reduction of the internal hernia, resection of necrotic segments of the bowel and a modified Ladd\u2019s procedure were performed. Postoperatively, the patient is total parenteral nutrition (TPN) dependent due to short bowel syndrome. A high index of suspicion with prompt imaging is paramount for paediatric patients with symptoms indicating intestinal obstruction.<\/jats:p>","DOI":"10.1136\/bcr-2022-254425","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T10:30:12Z","timestamp":1689157812000},"page":"e254425","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Midgut volvulus in a pediatric patient with chronic constipation, congenital intestinal malrotation and internal transmesocolic hernia"],"prefix":"10.1136","volume":"16","author":[{"given":"Emily","family":"Brezler","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery, WVU Medicine Children's Hospital, Morgantown, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Sico","sequence":"additional","affiliation":[{"name":"Pediatric Radiology, WVU Medicine Children's Hospital, Morgantown, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico G","family":"Seifarth","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Pediatric Surgery, WVU Medicine Children's Hospital, Morgantown, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,7,12]]},"reference":[{"key":"2025082723020111000_16.7.e254425.1","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.clinre.2013.01.005","article-title":"Partial intestinal Malrotation","volume":"37","author":"Daniel","year":"2013","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"2025082723020111000_16.7.e254425.2","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.suc.2016.08.011","article-title":"Intestinal rotation abnormalities and midgut volvulus","volume":"97","author":"Langer","year":"2017","journal-title":"Surgical Clinics of North America"},{"key":"2025082723020111000_16.7.e254425.3","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.1016\/S0022-3468(03)00416-0","article-title":"Small bowel obstruction caused by congenital Mesocolic hernia: case report","volume":"38","author":"Merrot","year":"2003","journal-title":"J Pediatr Surg"},{"key":"2025082723020111000_16.7.e254425.4","first-page":"57","article-title":"Radiological evaluation of internal abdominal Hernias","volume":"16","author":"Sel\u00e7uk","year":"2005","journal-title":"Turk J Gastroenterol"},{"key":"2025082723020111000_16.7.e254425.5","doi-asserted-by":"crossref","first-page":"432","DOI":"10.4066\/AMJ.2014.2179","article-title":"Congenital middle Mesocolic hernia: A case report","volume":"7","author":"Kannan","year":"2014","journal-title":"Australas Med J"},{"key":"2025082723020111000_16.7.e254425.6","doi-asserted-by":"crossref","DOI":"10.1093\/jscr\/rjz280","article-title":"A unique case of congenital Transmesocolic hernia with Malrotation in a 25-year-old female: a case report","volume":"2019","author":"Danial","year":"2019","journal-title":"J Surg Case Rep"},{"key":"2025082723020111000_16.7.e254425.7","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.amjsurg.2007.08.035","article-title":"The changing spectrum of intestinal Malrotation: diagnosis and management","volume":"194","author":"McVay","year":"2007","journal-title":"Am J Surg"},{"key":"2025082723020111000_16.7.e254425.8","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.05.0644"},{"key":"2025082723020111000_16.7.e254425.9","doi-asserted-by":"publisher","DOI":"10.1542\/pir.2018-0334"},{"key":"2025082723020111000_16.7.e254425.10","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-5-1"},{"key":"2025082723020111000_16.7.e254425.11","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1148\/rg.2018170163","article-title":"Acute mesenteric ischemia: Multidetector CT findings and Endovascular management","volume":"38","author":"Kanasaki","year":"2018","journal-title":"Radiographics"},{"key":"2025082723020111000_16.7.e254425.12","doi-asserted-by":"crossref","first-page":"2050312120923227","DOI":"10.1177\/2050312120923227","article-title":"Still time to perform intestinal Revascularization in patients with acute mesenteric ischemia with Peritonitis: an analysis of bowel viability in Resections","volume":"8","author":"Hayashi","year":"2020","journal-title":"SAGE Open Med"},{"key":"2025082723020111000_16.7.e254425.13","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.10.1054"},{"key":"2025082723020111000_16.7.e254425.14","doi-asserted-by":"publisher","DOI":"10.1023\/B:DDAS.0000042232.98927.91"},{"key":"2025082723020111000_16.7.e254425.15","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2014-207499","article-title":"Left-sided Transmesocolic Herniation of small bowel in an otherwise unaffected abdomen","volume":"2015","author":"Agarwal","year":"2015","journal-title":"BMJ Case Rep"},{"key":"2025082723020111000_16.7.e254425.16","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2020-321082"},{"key":"2025082723020111000_16.7.e254425.17","unstructured":"Pansky B . Review of medical Embryology. 1982."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-254425","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:02:09Z","timestamp":1756360929000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-254425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":17,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7,12]]},"published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1136\/bcr-2022-254425"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-254425","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]}}}