Intestinal malrotation in the older child: common diagnostic pitfalls

Amah, CC; Agugua-Obianyo, N.E.N.; Ekenze, Sebastian O.

doi:10.4314/wajr.v11i1.34187

Cited by 1 publication

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“…Two (20%) patients were readmitted for adhesive intestinal obstruction in this report. This compares to 7-24% incidence of postoperative adhesions in previous reports [7][8][9][10]. The steps of the Ladd's procedure required much handling and manipulation of the bowel increasing the risk of adhesion.…”

Section: Discussionmentioning

confidence: 69%

“…The incidence of symptomatic malrotation is reported to be 1 in 5000 live births [6].The incidence of this condition in African population is not known. However Amah [7] in Enugu South East Nigeria reported 8 cases over duration of 4 years while Ameh [8] in Zaria Northern Nigeria reported 14 cases over period of 18years. More than half of the patients present with the symptoms during the first month of life, and virtually all have bile-stained vomiting.…”

Section: Introductionmentioning

confidence: 99%

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Childhood Intestine Rotation Anomalies in Aba, Nigeria

Ekpemo¹,

Eweputanna²,

Nkwo³

2019

ASS

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Background: The anomalies of rotation, migration and fixation of the intestines are of intense interest to the pediatric surgeon, as they are frequently associated with midgut volvulus which has catastrophic consequences when diagnosis is delayed or even not considered. This study evaluates the outcomes of surgical management of intestinal malrotation in children. Materials and Methods: The medical records of all patients with symptomatic malrotation, who underwent surgery between January 2010 and September 2018, were reviewed. Patients' demographic characteristics, clinical features management, complications, and outcome were evaluated. Results: Ten patients (nine boys and a girl) underwent surgery for malrotation at a median age of 3months. Eight presented with acute symptoms and two with chronic symptoms. All the patients had symptoms of intermittent or complete upper intestinal obstruction, and malrotation was documented by an upper gastrointestinal contrast study in six of them. Volvulus was found at the time of surgery in 5 patients, three of whom were neonates. Eight patients were treated by Ladd's operation. Median length of stay was 10 days. One patient with massive bowel gangrene due to volvulus had right hemicolectomy. There was two perioperative death from anastomostic leak and septicaemia with an overall mortality of 20%. Conclusion: Bowel gangrene from volvulus contributes to mortality and small bowel adhesive intestinal obstruction is a cause of morbidity and mortality following surgery for intestinal malrotation. Neonates with bilious vomiting should raise the suspicion of malrotation until proven otherwise and given prompt intervention.

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Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%