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Epidemiological study on intestinal volvulus without malrotation in VLBW infants
  1. Yasemin Yarkin1,
  2. Christoph Maas1,
  3. Axel R Franz1,2,
  4. Hans-Joachim Kirschner3,
  5. Christian F Poets1
  1. 1 Department of Neonatology, University Children’s Hospital Tübingen, Tübingen, Germany
  2. 2 Center for Paediatric Clinical Studies, University Children’s Hospital, Tübingen University Hospital, Tübingen, Germany
  3. 3 Department of Paediatric Surgery and Pediatric Urology, University Children’s Hospital Tübingen, Tübingen, Germany
  1. Correspondence to Dr Yasemin Yarkin, Department of Neonatology, University Children`s Hospital, Tübingen 72076, Germany; Yasemin.Yarkin{at}


Background We conducted a monthly epidemiological survey in Germany to detect the prevalence of volvulus without malrotation (VWM) in very low birthweight (VLBW) infants and to identify factors for a better distinction between this rare and life-threatening event and other acute abdominal diseases in preterm infants.

Methods Throughout 2014 and 2015, every paediatric department in Germany was asked to report cases of VWM in infants with birth weights <1500 g to the Surveillance Unit for Rare Paediatric Conditions in Germany. Hospitals reporting a case were asked to return an anonymised questionnaire and discharge letter.

Results Of 36 cases reported, detailed information was submitted on 29, with 26 meeting entry criteria. With 9896 and 10 140 VLBW infants born in Germany in 2014 and 2015, respectively, we estimated a prevalence of 1.52/1000 VLBW infants for 2014 and 1.08/1000 in 2015. No specific early symptom could be determined. 10% died, and 21% of infants developed short bowel syndrome. Calculated from all verified VWM arise death in 8% and a short bowel syndrome in 15%.

Conclusion VWM is a rare source of acute abdomen in VLBW infants. No specific signs and symptoms potentially facilitating an early recognition of VWM could be found from this survey. Because the rates of death and short bowel syndrome are high, VWM should always be considered early in an acute abdomen in a VLBW infant.

  • acute abdomen in preterm VLBW infants
  • malrotation without volvulus
  • epidemiology
  • mortality
  • injury prevention

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  • Contributors CM designed the study and the questionnaire, supervised data analyses and reviewed and revised the manuscript making important intellectual contributions. ARF was study coordinator, contributed to study and questionnaire design, supervised data analyses and reviewed and revised the manuscript making important intellectual contributions. YY was responsible for the data collection and recording and reviewing and revising the questionnaires. H-JK reviewed and revised the manuscript for important intellectual contributions. CFP supervised the study as the head of department and reviewed and revised the manuscript for important intellectual contributions. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The authors have indicated the statements in the submitted article are their own and not an official position of the institution.

  • Competing interests None declared.

  • Ethics approval The study protocol, including a parental consent waiver, was approved by the ethics committee of Tübingen University Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There is no additional unpublished data available.