Midgut volvulus in a 4-year-old male

Excerpt

A 4 year-old boy presented with sudden, intense, and constant abdominal pain that awoke him from sleep. He had experienced no nausea or vomiting, and stooling had been regular. Vital signs were blood pressure: 133/87, heart rate: 120, respiratory rate: 28, SaO2: 99%, and temperature: 35.7. On physical exam the patient was writhing in pain with a mildly distended abdomen, with bowel sounds present and guaiac negative stool. Laboratory studies revealed a white blood cell count of 28,000. Abdominal x-ray revealed findings compatible with small bowel obstruction (Figs. 1, 2, 3), and subsequent upper GI series raised suspicion for midgut volvulus (Figs. 4, 5). The patient received IV fluids and morphine, and was emergently taken to the operating room.

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