A rare case of combined surgical pathology of the gastrointestinal tract in the practice of a neonatologist and a pediatric

Congenital malformations of the gastrointestinal tract are the third most common among all malformations and are one of the main causes of neonatal mortality. In most cases, they require urgent surgical intervention, so it is so important to diagnose this pathology in time and choose a treatment strategy. However, despite the fact that gastrointestinal tract malformations usually manifest themselves in the first days of life, their diagnosis can be difficult in the case of combined defects that give a similar clinical picture. In the case we presented, we described a combination of Ladd’s syndrome and duodenal membrane in a newborn, which caused high intestinal obstruction.

Ladd’s syndrome, intestinal obstruction, duodenal membrane, intestinal volvulus, newborns, malformations

1. Verma R. Congenital Anomalies of the Gastrointestinal Tract [Internet]. Congenital Anomalies in Newborn Infants - Clinical and Etiopathological Perspectives.IntechOpen. 2021. doi: 10.5772/intechopen.92588.

2. Svetanoff W.J., Srivatsa S., Diefenbach K., Nwomeh B.C. Diagnosis and management of intestinal rotational abnormalities with or without volvulus in the pediatric population. Semin Pediatr Surg. 2022 Feb;31(1):151141. doi: 10.1016/j.sempedsurg.2022.151141.

3. Langer J.C.Intestinal Rotation Abnormalities and Midgut Volvulus. Surg Clin North Am. 2017 Feb;97(1):147-159. doi: 10.1016/j.suc.2016.08.011.

4. Zhu H., Zheng S., Alganabi M., Peng X., Dong K., Pierro A. et al. Reoperation after Ladd’s procedure in the neonatal period. Pediatr Surg Int. 2019 Jan;35(1):117-120. doi: 10.1007/s00383-018-4382-6.

5. Naddouri J., Khouah R., Sekkat H. et al. Small bowel obstruction in adults, Ladd’s band is an exceptional cause: a case report. Pan Afr Med J. 2024 Jan 26;47:34. doi: 10.11604/pamj.2024.47.34.36435.

6. Al Smady M.N., Hendi S.B., AlJeboury S., Al Mazrooei H., Naji H. Appendectomy as part of Ladd’s procedure: a systematic review and survey analysis. Pediatr Surg Int. 2023 Apr 3;39(1):164. doi: 10.1007/s00383-023-05437-7.

7. Nakayama D.K. William Ladd before the Halifax explosion. J Pediatr Surg. 2017 Dec;52(12):2093-2096. doi: 10.1016/j.jpedsurg.2017.08.047.

8. Arnaud A.P., Suply E., Eaton S. et al. Laparoscopic Ladd’s procedure for malrotation in infants and children is still a controversial approach. J Pediatr Surg. 2019 Sep;54(9):1843-1847. doi: 10.1016/j.jpedsurg.2018.09.023.

9. Svarich V.G., Kagantsov I.M., Svarich V.A. Sindrom Ledda u detei starshego vozrasta [Ladd’s syndrome in older children]. Khirurgiia (Mosk). 2022;(11):61-67.Russian. doi: 10.17116/hirurgia202211161.

10. Pelayo J.C., Lo A.Intestinal Rotation Anomalies. Pediatr Ann. 2016 Jul 1;45(7): e247-50. doi: 10.3928/00904481-20160602-01.

11. Drewett M., Johal N., Keys C., J Hall N., Burge D. The burden of excluding malrotation in term neonates with bile stained vomiting. Pediatr Surg Int. 2016 May;32(5):483-6. doi: 10.1007/s00383-016-3877-2.

12. Zyuzina O.A. Ladd’s Syndrome in Newborns. Journal of radiology and nuclear medicine. 2023;104(2):143-150. (In Russ.) doi: 10.20862/0042-4676-2023-104-2-143-150.@@ Зюзина О.А. Синдром Ледда у новорожденных. Вестник рентгенологии и радиологии. 2023; 104(2): 143-50. doi: 10.20862/0042-4676-2023-104-2-143-150.

13. Lodwick D.L., Minneci P.C., Deans K.J. Current surgical management of intestinal rotational abnormalities. Curr Opin Pediatr. 2015 Jun;27(3):383-8. doi: 10.1097/MOP.0000000000000215.

14. Xie W., Li Z., Wang Q., Wang L., Pan Y., Lu C. Laparoscopic vs open Ladd’s procedure for malrotation in neonates and infants: a propensity score matching analysis. BMC Surg. 2022 Jan 26;22(1):25. doi: 10.1186/s12893-022-01487-1.

15. Andrade G.B.H., Marin B.S., Medeiros D.N.M., Yamanari M.G.I., Troster E.J. Vomiting in newborns as a result of a duodenal membrane: two case reports. Einstein (Sao Paulo). 2020 Nov 27;18: eRC4641. doi: 10.31744/einstein_journal/2020RC4641.

16. Mustaqim K., Mohd Shah M.S., Muhammad Asri N.A. Double Whammy: Duodenal Stenosis and Gastrointestinal Malrotation. Cureus. 2023 Mar 14;15(3): e36137. doi: 10.7759/cureus.36137.

17. Bartholmot C., Faure J.M., Grosjean F. et al. Prenatal diagnosis of antenatal midgut volvulus: Specific ultrasound features. Prenat Diagn. 2019 Jan;39(1):16-25. doi: 10.1002/pd.5392.

18. Langer J.C.Intestinal Rotation Abnormalities and Midgut Volvulus. Surg Clin North Am. 2017 Feb;97(1):147-159. doi: 10.1016/j.suc.2016.08.011. 16.

19. Saba T.G., Geddes G.C., Ware S.M. et al. A multi-disciplinary, comprehensive approach to management of children with heterotaxy. Orphanet J Rare Dis. 2022 Sep 9;17(1):351. doi: 10.1186/s13023-022-02515-2.