Malrotation syndrome resulting in fatal ileus in children

Arch Kriminol. 2016 Sep;238(3-4):128-135.
[Article in English, German]


Background: This report deals with two deaths of children involving intestinal volvulus, i. e. a pathological knotting and twisting of the mesenterial root on the basis of congenital malrotation followed by obstruction and extensive ischaenia.

Case reports: (1) A 10-year-old girl (premature, 25th week) with severe disability, amaurosis and epilepsy was admitted to hospital due to general agitation and a bloated abdomen without peristaltic sounds, but died some hours later. Autopsy revealed a volvulus of 2/3 of the small intestine based on congenital malrotation with additional clamping of the intestine underneath adhesions (previous appendectomy). The abdominal cavity showed beginning peritonitis as the cause of death. (2) A 2-month-old premature male baby (surviving twin, 29th week) with a persisting ductus arteriosus was hospitalised for four weeks after failed vascular surgery due to acute general deterioration. Radiological diagnostics using a contrast medium revealed a vascular anomaly (right-sided aortic arch). Around 10 hours later, the infant developed an acute abdomen with ileus symptoms. Emergency surgery showed infarction of the entire small intestine due to an anti-clockwise 180⁰-volvulus, with death occurring 24h later. Further examination showed a malrotation as anomaly. Apparently, the volvulus had been caused by extensive use of contrast medium resulting in increased intestinal mobility.

Publication types

  • Case Reports

MeSH terms

  • Angiography
  • Child
  • Contrast Media / adverse effects
  • Digestive System Abnormalities / complications*
  • Digestive System Abnormalities / pathology*
  • Diseases in Twins / pathology
  • Ductus Arteriosus, Patent / surgery
  • Fatal Outcome
  • Female
  • Gangrene
  • Gastrointestinal Motility / drug effects
  • Heart Arrest / etiology*
  • Heart Arrest / pathology*
  • Humans
  • Ileus / pathology*
  • Infant
  • Infant, Premature, Diseases / pathology
  • Intestinal Volvulus / chemically induced
  • Intestinal Volvulus / complications*
  • Intestinal Volvulus / pathology*
  • Intestine, Large / drug effects
  • Intestine, Large / pathology
  • Intestine, Small / drug effects
  • Intestine, Small / pathology
  • Ligation
  • Male
  • Pulmonary Artery / surgery


  • Contrast Media

Supplementary concepts

  • Volvulus Of Midgut