2.1 The Ladd's Procedure for Correction of Intestinal Malrotation With Volvulus in Children

Abstract

MALROTATION that occurs when the embryonic, two‐part, intestinal rotation does not proceed normally results in an abnormal anatomical position of the intestines. VOLVULUS OCCURS when the intestines are not fixated to the intestinal wall but are suspended on a narrow stalk of mesenteric tissue containing the supplying blood vessels. This formation allows the intestines to twist on themselves and cut off the blood supply to the bowel. WHEN MALROTATION WITH VOLVULUS is diagnosed, emergency surgery must be performed to untwist the intestines, restore blood flow, and widen the mesentery. AORN J 85 (February 2007) 300–312. © AORN, Inc, 2007.

Persistent Nonbilious Vomiting in a Child: Possible Duodenal Webbing

“…The most common presentation of malrotation is bilious vomiting due to duodenal obstruction from intermittent midgut volvulus rather than compression by Ladd’s bands or kinking of the duodenum [4]. However, in some patients, malrotation is discovered incidentally during radiographic studies or during laparotomy performed for other indications [1,2,5,6]. …”

“…A symptomatic association between a malrotation and a congenital duodenal web is rare and few cases have been reported in the literature. The true incidence of malrotation is not fully known; however, it is reported as approximately 1 in 500 live births [1,2]. The incidence of duodenal web as a cause of intestinal obstruction is reported to be between 1:10,000 to 1:40,000 [3,4].…”

Duodenal web associated with malrotation and review of literature

“…As the bowel develops in the fetus, it migrates out of the abdominal wall through the umbilical cord to receive nutrition [1]. This happens around Week 6 of gestation.…”

“…The incidence of malrotation is ∼1:500 births and the symptomatic incidence is 1:6000 [1, 2]. The incidence of duodenal web as a cause of intestinal obstruction is 1:10 000–1:40 000 [3].…”

Surgical Treatment of Rare Combination of Intestinal Malrotation with Secondary Lymphangiectasia

“…Любые нарушения вращения могут привести к патологической фиксации. Кроме того, врожденные фиброзные спайки (тяжи Ледда), образующиеся при нару-шении ротации кишки, могут стать причиной обструкции кишки и непроходимости [3,4].…”