“…Contrast radiography of the upper gastrointestinal tract is the gold standard to diagnose intestinal malrotation, with an accuracy between 80% and 100%. 1 These images enable the identification of the duodenojejunal flexure located to the right of the spinal column. Other tests include contrasted abdominal CT, abdominal ultrasound (US) and angiography/CT angiogram.…”
Section: Discussionmentioning
confidence: 99%
“…Intestinal malrotation is a congenital abnormality caused by incomplete rotation or absence of rotation of the primitive intestine along the axis of the upper mesenteric artery during embryonic development. [1][2][3] Embryonic development and its anatomical variations were described by Dott in 1923. 4 Intestinal malrotation is a rare condition among adultsprevalent in a mere 0.0001% to 0.19% of the population -, and it may be associated with other anatomical deformities.…”
Intestinal malrotation is a congenital anomaly caused by incomplete rotation or absence of rotation of the primitive intestine along the axis of the upper mesenteric artery during embryonic development. Embryonic development and its anatomical variations were described by Dott in 1923.Intestinal malrotation is a rare condition among adults – prevalent in a mere 0.0001% to 0.19% of the population –, and it may be associated with other anatomical deformities. It can be asymptomatic or manifest with varying intensity, from obstruction to necrosis of intestinal segments. In general, this abnormality is diagnosed in the first year of life; however, symptoms may appear later in life, making diagnosis in adults difficult on account of non-specific symptoms.In the present study, we report a case of intestinal malrotation associated with chronic non-specific symptoms progressing to mesenteric angina.
“…Contrast radiography of the upper gastrointestinal tract is the gold standard to diagnose intestinal malrotation, with an accuracy between 80% and 100%. 1 These images enable the identification of the duodenojejunal flexure located to the right of the spinal column. Other tests include contrasted abdominal CT, abdominal ultrasound (US) and angiography/CT angiogram.…”
Section: Discussionmentioning
confidence: 99%
“…Intestinal malrotation is a congenital abnormality caused by incomplete rotation or absence of rotation of the primitive intestine along the axis of the upper mesenteric artery during embryonic development. [1][2][3] Embryonic development and its anatomical variations were described by Dott in 1923. 4 Intestinal malrotation is a rare condition among adultsprevalent in a mere 0.0001% to 0.19% of the population -, and it may be associated with other anatomical deformities.…”
Intestinal malrotation is a congenital anomaly caused by incomplete rotation or absence of rotation of the primitive intestine along the axis of the upper mesenteric artery during embryonic development. Embryonic development and its anatomical variations were described by Dott in 1923.Intestinal malrotation is a rare condition among adults – prevalent in a mere 0.0001% to 0.19% of the population –, and it may be associated with other anatomical deformities. It can be asymptomatic or manifest with varying intensity, from obstruction to necrosis of intestinal segments. In general, this abnormality is diagnosed in the first year of life; however, symptoms may appear later in life, making diagnosis in adults difficult on account of non-specific symptoms.In the present study, we report a case of intestinal malrotation associated with chronic non-specific symptoms progressing to mesenteric angina.
“…Poderia também ser solicitada uma tomografia, considerada outro exame excelente para avaliar um quadro obstrutivo, podendo evidenciar relação inversa entre os vasos mesentéricos superiores (veia situada à esquerda da artéria), ausência ou hipoplasia do processo uncinado do pâncreas e alterações na disposição das alças e da transição duodenojejunal, situando-se à direita do abdome, conforme alguns autores citam em seus trabalhos. [1][2][3][4][5][6] O procedimento de Ladd consiste, primeiramente, na resolução de eventos agudos, como volvo e hérnia interna, depois lise das bandas de Ladd, apendicectomia profilática e reposicionamento das alças sem fixação. 3 Desde a década de 1990, a laparoscopia vem ganhando espaço na abordagem cirúrgica, ficando a laparotomia mais restrita a pacientes instáveis ou recém-nascidos.…”
Section: Discussionunclassified
“…Em adultos, a incidência é de 0,2%, porém por ser uma doença de maior prevalência pediátrica, o seu diagnóstico em adultos se torna difícil, aumentando o risco de desencadear consequências graves, tanto agudas como crônicas. 1…”
A má rotação intestinal é uma anomalia congênita de causa desconhecida, sendo vômitos biliosos um dos diagnósticos diferenciais na infância, e em adultos consiste em um difícil diagnóstico. Adolescente de 17 anos iniciou um quadro de dor mesogástrica, de caráter intermitente, com piora pós-prandial. Apresentou dores abdominais intensas, vômitos biliosos, desidratação e desnutrição severa. Foram realizadas endoscopia e seriografia digestiva alta, que sugeriram má rotação intestinal. O paciente foi submetido ao procedimento de Ladd por videolaparoscopia. Durante a cirurgia, foi achado o ceco em hipocôndrio esquerdo, estômago e primeira porção duodenal dilatada por presença de banda de Ladd na segunda porção duodenal. Foi realizado lise das bandas de Ladd, apendicectomia e reposicionamento das alças. Recebeu alta hospitalar após quatro dias. A má rotação intestinal em adultos é de difícil identificação e o procedimento de Ladd por videolaparoscopia é a técnica cirúrgica de escolha para esses pacientes sem complicações agudas.
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