Comparison of late results in patients with corrected intestinal malrotation with and without fixation of the mesentery

Stauffer, U. G.; Herrmann, Paul

doi:10.1016/s0022-3468(80)80393-9

Cited by 69 publications

(22 citation statements)

References 6 publications

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“…Although small bowel obstruction has been noted following Ladd's procedure, the incidence has been quite low. In 1980, Stauffer et al reported 5 (12%) of 41patients required further surgery for bowel obstruction [7]. Mehall et al [8] in 2002 reported similar results with persistent symptoms following surgery occurring in 11-13% and small bowel obstruction in 11%.…”

Section: Discussionmentioning

confidence: 93%

Long-term complications following intestinal malrotation and the Ladd’s procedure: a 15 year review

Murphy

Sparnon²

2006

Ped Surgery Int

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Section: Discussionmentioning

confidence: 93%

Long-term complications following intestinal malrotation and the Ladd’s procedure: a 15 year review

Murphy

Sparnon²

2006

Ped Surgery Int

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“…We believe that the only surgical technique which can guarantee the resolution of the problem of malrotation in any condition is a complete Ladd's procedure [64] plus prophylactic appendectomy and the corresponding correction of other accompanying malformations. If there is intestinal ischaemia, the affected section will be resected with a possible enterostomy and if there is an internal hernia, to free the paramesocolic sac.…”

Section: Discussionmentioning

confidence: 99%

Anomalies of intestinal rotation and fixation: consequences of late diagnosis beyond two years of age

et al. 2007

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The malrotation and no well fixation anomalies of the digestive tract is also frequent in older child, young and adult, with characteristic and specific clinical presentation. Actually, the diagnostic and treatment seem to be late, after suffering prolonged symptoms and/or in emergency. We present nine cases of anomalies in the embryonic development of the digestive tract which were diagnosed and treated in infants or young, all above 2 years old. Eight cases were of more or less complete intestinal malrotation; one of them was a complete malrotation with an intrinsic duodenal stenosis associated (no bands of Ladd) and another one was a right paramesocolic hernia, always accompanied by malrotation. The association with other extra-digestive anomalies, especially urological, was 70%. The predominant symptom was intermittent abdominal pain (IAP)-80%-sometimes accompanied by vomiting (35%) and episodes of diarrhoea (25%). In all the cases, while the clinical background was early, diagnosis was late. Indeed, in 60% of the cases diagnosis was made intra-operatively in emergency surgical interventions. The imaging procedures employed were scanning and Doppler ultrasound, CT scan, and contrast gastrointestinal series (GIS). Up to 30% of errors in interpretation occurred, although they were eventually corrected with other tests. The most reliable diagnostic procedures were GIS and CT scan with contrast, although partial interpretation errors occurred with the latter procedure. Surgery was essential in 80% of the pre-operative cases, and in another two it was required as a preventative measure. Post-operatively, there was notable persistence of SBS in the cases of intestinal necrosis, and of other lesser symptoms in the rest. We conclude that: intestinal malrotations and malfixations are still being diagnosed very late, with serious systemic consequences such as intestinal obstructions or necroses, and prolonged clinical suffering. This could all be avoided if more attention were paid to the digestive symptoms associated with IAP, and to subocclusion or other abdominal phenomena (distension,...), together with, in the case of doubt about the findings with the previous procedures, the opportune imaging tests (e.g., abdominal Doppler ultrasound, CT scan with contrast, and barium GIS). Unlike other authors, we consider that the morbidity/mortality associated with cases of late diagnosis of these anomalies is high, and calls for earlier surgical treatment.

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“…In another retrospective analysis, 5 of 41 children treated for malrotation underwent reoperation for obstruction and/or recurrent volvulus; however, these were all within a span of 7 months to 15 years after the original operation. 5 Intestinal malrotation with or without volvulus and obstruction in adults is rare, with estimated incidence at 0.2%. 6 Malrotation presents in adults commonly with obstructive symptoms or chronic abdominal pain, occasionally with an acute exacerbation; however, it may also present with signs of strangulation and ischemia.…”

Section: Discussionmentioning

confidence: 99%

Colonic Volvulus in an Adult After Childhood Ladd's Procedure for Malrotation

Addink

Merchant

Bistolarides

2012

Journal of Surgical Education

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Comparison of late results in patients with corrected intestinal malrotation with and without fixation of the mesentery

Cited by 69 publications

References 6 publications

Long-term complications following intestinal malrotation and the Ladd’s procedure: a 15 year review

Long-term complications following intestinal malrotation and the Ladd’s procedure: a 15 year review

Anomalies of intestinal rotation and fixation: consequences of late diagnosis beyond two years of age

Colonic Volvulus in an Adult After Childhood Ladd's Procedure for Malrotation

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