Neonatal intestinal volvulus. Review of our experience over the last 20 years

Background: There are two types of volvulus: midgut (MGV) and segmental (SV). Patients with different types of volvulus are often included in the same case series, which may affect the perception of how severe "intestinal volvuli" are. We aimed to create a predictive model of death and intestinal failure (IF) in neonatal intestinal volvulus. Methods: Retrospective cohort study including all patients with MGV and SV up to 60 days of life admitted to a tertiary hospital in Spain over a 20-year-period (1999-2019). A comparison between groups and a logistic regression model for mortality and IF were done. Results: We identified 39 patients: 28 MGV and 11 SV. Prenatal diagnosis, intestinal atresia, meconial conditions, cystic fibrosis, and intestinal resection were significantly more frequent in SV. Need of inotropic durgs, birth weight (BW) 1500-2499g, BW 1000-1499g and <1000g increased the risk of death. SV and gestational age <37 weeks increased the risk of IF or dying. Conclusions: SV and MGV are different entities. Low BW and need for inotropic drugs are risk factors for death. Surgical examination should be performed to rule out volvulus in neonates presenting with such risk factors. Prematurity and SV are risk factors for IF.