Malrotation and abdominal pain: A diagnosis eluding the unprepared mind

Arunachalam, Rathnaswami

doi:10.1007/s12664-015-0615-y

Cited by 5 publications

(4 citation statements)

References 18 publications

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“…Other series on malrotation also reported abdominal pain as the most common symptom [14,17]. The abdominal pain may be chronic and crampy due to partial intermittent intestinal obstruction or may be severe and acute in cases of midgut volvulus [22]. Non-specific symptoms such as vomiting, diarrhea, bloating, dyspepsia and early satiety have been reported in patients with intestinal malrotation.…”

Section: Discussionmentioning

confidence: 96%

Intestinal Malrotation in Children: Experience of a Tertiary Care Hospital in a Developing Country

Emeka¹

2020

Janaki Med. Coll. J. Med. Sci.

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Background and Objectives: Intestinal malrotation is a congenital disorder resulting from abnormal rotation of the intestine during fetal development. The aim of this study was to evaluate our experience in the management of pediatric patients with intestinal malrotation. Material and Methods: This was a retrospective study of children aged 3 years and below who were treated for intestinal malrotation between January 2014 and December 2018 at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria. Results: Sixty-one patients had laparotomy for intestinal malrotation during the study period. There was predominance of male neonates and the age range was 10 days to 3 years. Abdominal pain and upper gastrointestinal tract contrast study were the most common symptom and investigation respectively. Intestinal obstruction caused by congenital (Ladd’s) bands was the most common intraoperative finding and Ladd’s procedure was the most performed surgical procedure. Most patients did not develop any post-operative complications. However, surgical site infection was the most common complication following surgery. Mortality occurred in 8 (13.1%) patients. Conclusion: Intestinal malrotation symptoms occur mainly in male neonates and abdominal pain is a common and consistent symptom. Upper gastrointestinal contrast study is diagnostic. There are morbidity and mortality associated with treatment of intestinal malrotation.

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Section: Discussionmentioning

confidence: 96%

Intestinal Malrotation in Children: Experience of a Tertiary Care Hospital in a Developing Country

Emeka¹

2020

Janaki Med. Coll. J. Med. Sci.

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Section: Discussionmentioning

confidence: 99%

“…[11] The clinical significance of malrotation abnormalities lies within 2 key features: an abnormally positioned duodenojejunal loop compressed by peritoneal Ladd bands eliciting obstruction of the duodenum and narrow fixation of the base of the mesentery placing the SMA at risk of volvulus. [12,13] The patient was asymptomatic when not pregnant, while nausea and vomiting occurred during pregnancy, which may be due to abnormal duodenal torsion or folding with enlargement of the uterus, resulting in duodenal obstruction.…”

Section: Discussionmentioning

confidence: 99%

Midgut malrotation presenting with hyperemesis gravidarum: A case report

Zhao

Yang

et al. 2022

Medicine

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Rationale: Midgut malrotation is a rare congenital abnormality resulting from failure of complete intestinal rotation and subsequent fixation during early fetal development. There appeared to be no obvious symptoms in most patients, and a few patients may exhibit symptoms similar to hyperemesis gravidarum, such as nausea and vomiting. Here, we present a case of midgut malrotation presenting as hyperemesis gravidarum.Patient concerns: A 27-year-old woman with an intrauterine pregnancy of 27 + 6 weeks complained of severe nausea and vomiting for 2 weeks.Diagnosis: Magnetic resonance imaging showed obvious dilatation in the proximal part of the duodenum and gastric cavity and the absence of a duodenal path dorsal to the superior mesenteric artery, which was diagnosed as midgut malrotation.Interventions: Considering that the patient's vital signs were stable, without manifestation of peritonitis or the risks of surgery to the fetus, conservative treatment was adopted. Unfortunately, the fetus developed severe hydrocephalus at 32 weeks. The patient and her family decided to abandon the fetus, and a mid-trimester-induced abortion was performed.Outcomes: The related symptoms completely disappeared after delivery, and the relevant examination after discharge also confirmed the presence of midgut malrotation without gastrointestinal discomfort within 1 year after delivery.Lessons: Midgut malrotation can be considered as a differential diagnosis of hyperemesis gravidarum. Conservative treatment under close monitoring is desirable in pregnant women diagnosed with midgut malrotation.

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“…The abdominal pain may be chronic and crampy due to partial intermittent intestinal obstruction or may be severe and acute in cases of midgut volvulus [22]. Non-specifi c symptoms such as vomiting, diarrhea, bloating, dyspepsia and early satiety have been reported in patients with intestinal malrotation.…”

Section: Discussionmentioning

confidence: 99%

Profile of children with intestinal malrotation: A tertiary hospital experience in a developing country

Emeka¹

2020

Arch Clin Gastroenterol

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Malrotation and abdominal pain: A diagnosis eluding the unprepared mind

Cited by 5 publications

References 18 publications

Intestinal Malrotation in Children: Experience of a Tertiary Care Hospital in a Developing Country

Intestinal Malrotation in Children: Experience of a Tertiary Care Hospital in a Developing Country

Midgut malrotation presenting with hyperemesis gravidarum: A case report

Profile of children with intestinal malrotation: A tertiary hospital experience in a developing country

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