{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T06:28:02Z","timestamp":1786343282109,"version":"build-2736575974"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Jejunoileal atresia is most commonly attributed to intrauterine mesenteric vascular accidents. Both segmental volvulus and enteric duplication cysts are recognized yet uncommon causes of fetal vascular compromise capable of inducing intestinal ischemia. The simultaneous occurrence of ileal atresia, segmental volvulus, and enteric duplication cyst in a single neonate is exceedingly rare and offers valuable insight into the vascular pathogenesis of intestinal atresia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We report the case of a male term neonate admitted eleven hours after birth for bilious vomiting and progressive abdominal distension. Plain abdominal radiography revealed multiple air-fluid levels, and contrast enema demonstrated a microcolon with characteristic \u201cstring-of-beads\u201d filling defects in the distal ileum consistent with meconium pellets. Exploratory laparotomy identified a type IIIa distal ileal atresia located 20\u2005cm from the ileocecal valve, associated with a segmental volvulus twisting around a 3\u2005cm cystic enteric duplication. The volvulated bowel segment, duplication cyst, and dilated proximal ileum were resected, and a primary end-to-end ileoileal anastomosis was performed. Histopathology confirmed cystic ileal duplication with bilateral ileal atresia at the resection margins. Despite an initially stable postoperative course, the infant developed severe bronchiolitis with respiratory failure and died on postoperative day 10.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This rare neonatal triad supports the hypothesis that enteric duplication cysts may act as intrauterine lead points for segmental volvulus, triggering mesenteric vascular compromise and secondary ileal atresia. Any neonate presenting with distal bowel obstruction and microcolon should prompt consideration of complex intrauterine vascular events. Prompt surgical exploration remains essential to maximize intestinal preservation and improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1888442","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:31:28Z","timestamp":1786339888000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enteric duplication cyst as a lead point for intrauterine segmental volvulus resulting in type IIIa ileal atresia: a neonatal case report and focused literature review"],"prefix":"10.3389","volume":"14","author":[{"given":"Mariam","family":"Marzouki","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery \u201cHichem Said\u201d, Children\u2019s Hospital of Tunis, University Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malek","family":"Mezni","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery \u201cHichem Said\u201d, Children\u2019s Hospital of Tunis, University Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosra","family":"Ben Ahmed","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery \u201cHichem Said\u201d, Children\u2019s Hospital of Tunis, University Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiem","family":"Hammouda","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery \u201cHichem Said\u201d, Children\u2019s Hospital of Tunis, University Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rim","family":"Ben Aziza","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Center of Maternity and Neonatology of Tunis, University Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imen","family":"Ben Ismail","sequence":"additional","affiliation":[{"name":"Department of Visceral and Digestive Surgery, Traumatology and Great Burns Center Ben Arous, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Said","family":"Jlidi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery \u201cHichem Said\u201d, Children\u2019s Hospital of Tunis, University Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Khemir","sequence":"additional","affiliation":[{"name":"Pathology Department, Salah Azaiez Institute, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imen","family":"Abess","sequence":"additional","affiliation":[{"name":"Pathology Department, Salah Azaiez Institute, University of Tunis El Manar","place":["Tunis, Tunisia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"953852","DOI":"10.3389\/fped.2022.953852","article-title":"Evaluation of postoperative feeding strategies in children with intestinal atresia: a single-center retrospective study","volume":"10","author":"Wang","year":"2022","journal-title":"Front Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1007\/BF01658697","article-title":"Diagnosis and treatment of jejunoileal atresia","volume":"17","author":"Touloukian","year":"1993","journal-title":"World J Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1016\/S0140-6736(55)92852-X","article-title":"Congenital intestinal atresia: observations on its origin","volume":"269","author":"Louw","year":"1955","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1016\/0022-3468(94)90111-2","article-title":"Mesenteric defects as a cause of intestinal volvulus without malrotation and as the possible primary etiology of intestinal atresia","volume":"29","author":"Black","year":"1994","journal-title":"J Pediatr Surg"},{"key":"B5","first-page":"37","article-title":"Outcome of jejuno-ileal atresia associated with intraoperative finding of volvulus of small bowel","volume":"1","author":"Sinha","year":"2012","journal-title":"J Neonatal Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"213","DOI":"10.4236\/ojped.2016.63030","article-title":"Intra-uterine proximal loop volvulus in association with ileal atresia: a pointer to possible aetiology of small bowel atresias","volume":"6","author":"Mohammad","year":"2016","journal-title":"Open J Pediatr"},{"key":"B7","doi-asserted-by":"publisher","first-page":"16","DOI":"10.47338\/jns.v9.522","article-title":"In-utero segmental volvulus around vitellointestinal duct remnants leading to ileal atresia and stenosis: a case series","volume":"9","author":"Deshpande","year":"2020","journal-title":"J Neonatal Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/s40792-023-01645-4","article-title":"Intestinal volvulus in utero causing torsion of dilated bowel with ileal atresia: a case report","volume":"9","author":"Toyama","year":"2023","journal-title":"Surg Case Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1016\/jpsu.2003.50197","article-title":"Gastrointestinal duplications","volume":"38","author":"Puligandla","year":"2003","journal-title":"J Pediatr Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"43","DOI":"10.21699\/jns.v7i4.820","article-title":"Duplication cyst with intestinal volvulus causing intestinal atresia\/stenosis in neonates","volume":"7","author":"Mirza","year":"2018","journal-title":"J Neonatal Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"102105","DOI":"10.1016\/j.epsc.2021.102105","article-title":"Neonatal enteric duplication cyst with segmental gut volvulus","volume":"75","author":"Ali","year":"2021","journal-title":"J Pediatr Surg Case Rep"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e230035","DOI":"10.1148\/rg.230035","article-title":"Imaging features of neonatal bowel obstruction","volume":"43","author":"Gerrie","year":"2023","journal-title":"Radiographics"},{"key":"B13","doi-asserted-by":"publisher","first-page":"102664","DOI":"10.1016\/j.epsc.2023.102664","article-title":"Congenital mesenteric defect with distal ileal atresia and segmental volvulus in a neonate: a case report","volume":"89","author":"Mili","year":"2023","journal-title":"J Pediatr Surg Case Rep"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/jcu.21896","article-title":"Sonographic diagnosis of fetal intestinal volvulus with ileal atresia: a case report","volume":"41","author":"Yu","year":"2013","journal-title":"J Clin Ultrasound"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1442866","DOI":"10.3389\/fped.2024.1442866","article-title":"Prenatal diagnosis of midgut volvulus by fetal MRI: a retrospective study","volume":"12","author":"Kou","year":"2024","journal-title":"Front Pediatr"},{"key":"B16","doi-asserted-by":"publisher","first-page":"79","DOI":"10.4103\/0971-9261.25929","article-title":"Treatment strategies in the management of jejunoileal and colonic atresia","volume":"11","author":"Chadha","year":"2006","journal-title":"J Indian Assoc Pediatr Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1055\/s-0043-1772173","article-title":"Neonatal intestinal segmental volvulus: what are the differences with midgut volvulus?","volume":"34","author":"Casalino","year":"2024","journal-title":"Eur J Pediatr Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1375","DOI":"10.1016\/j.jpedsurg.2020.08.029","article-title":"Comparison of total midgut volvulus and segmental volvulus in neonates","volume":"56","author":"Chung","year":"2020","journal-title":"J Pediatr Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1111\/apa.16167","article-title":"Distinguishing outcomes of neonatal intestinal volvulus: review of our experience over the last 20 years","volume":"111","author":"Maya-Enero","year":"2022","journal-title":"Acta Paediatr"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1888442\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:31:29Z","timestamp":1786339889000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2026.1888442\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,10]]},"references-count":19,"alternative-id":["10.3389\/fped.2026.1888442"],"URL":"https:\/\/doi.org\/10.3389\/fped.2026.1888442","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,10]]},"article-number":"1888442"}}