Malrotation of the Intestine in Children

Abstract

Intestinal malrotation may be complicated by volvulus and intestinal necrosis. One hundred two children (64 male, 38 female) undergoing surgical abdominal exploration from 1977 to 1987 had malrotation. Fifty-two patients were less than 7 days of age, 13 from 8 to 30 days, 26 from 31 to 365 days, and 11 were older than 1 year of age. Of infants, 39 of 65 had 40-week gestations, 18 of 65 had 36- to 39-week gestations, and 8 of 65 had less than 36-week gestations. Chief symptomatology included: bilious emesis (47), intestinal obstruction (19), abdominal pain (11), and bloody stools (7). Seventy patients had congenital anomalies (50 single, 20 multiple). Diagnostic evaluations included 56 upper gastrointestinal series and 27 barium enemas. Each patient underwent correction of malrotation and appendectomy, and correction of congenital anomalies (omphalocele-9, gastroschisis-6, diaphragmatic hernia-7). Complications included short gut (2), sepsis (5), feeding difficulties (2), pneumonia (3), small bowel obstruction (2), and other (15). Nine patients (8.8%) died (trisomy 18-1, trisomy 13-1, intestinal necrosis-3, hepatic failure-1, prematurity-1, other sepsis-2). Two hundred sixteen children with intestinal malrotation have been treated from 1937 to 1987. Mortality rate has improved from 23% to 2.9%.

Study of a Typical Presentations in Congenital Diaphragmatic Hernia

“…[7] and Malrotation of Midgut. [8] are noticed in older children. Recurrent diaphragmatic hernia and small bowel obstruction are the dominant surgical challenges following initial repair.…”

Cystic fibrosis and intrauterine death

“…Timing of normal gut rotation in the first trimester of pregnancy, when the intestine is partially obliterated and meconium has not yet been formed, is consistent with the observation that CF does not seem to increase the risk of malrotation. 4 Malrotation may, therefore, have independently predisposed to volvulus in the present case. However, there is ample evidence that CF itself can cause intrauterine gut obstruction and volvulus.…”

Malrotación intestinal con vólvulo, asociada a hiperglucemia grave por estrés

“…9,12 El tratamiento es quirúrgico, se realiza la operación de Ladd para prevenir vólvulos recurrentes y la mortalidad de este procedimiento es menor al 3%. 13 n BIBLIOGRAFÍA…”