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%.
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- Andrassy R. J., Mahour G. H. Malrotation of the midgut in infants and children: a 25-year review. Arch Surg. 1981 Feb;116(2):158–160. doi: 10.1001/archsurg.1981.01380140020004. [DOI] [PubMed] [Google Scholar]
- Berdon W. E., Baker D. H., Bull S., Santulli T. V. Midgut malrotation and volvulus. Which films ar most helpful? Radiology. 1970 Aug;96(2):375–384. doi: 10.1148/96.2.375. [DOI] [PubMed] [Google Scholar]
- Brennom W. S., Bill A. H. Prophylactic fixation of the intestine for midgut nonrotation. Surg Gynecol Obstet. 1974 Feb;138(2):181–184. [PubMed] [Google Scholar]
- Powell D. M., Othersen H. B., Smith C. D. Malrotation of the intestines in children: the effect of age on presentation and therapy. J Pediatr Surg. 1989 Aug;24(8):777–780. doi: 10.1016/s0022-3468(89)80535-4. [DOI] [PubMed] [Google Scholar]
- SNYDER W. H., Jr, CHAFFIN L. Embryology and pathology of the intestinal tract: presentation of 40 cases of malrotation. Ann Surg. 1954 Sep;140(3):368–379. doi: 10.1097/00000658-195409000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Simpson A. J., Leonidas J. C., Krasna I. H., Becker J. M., Schneider K. M. Roentgen diagnosis of midgut malrotation: value of upper gastrointestinal radiographic study. J Pediatr Surg. 1972 Apr;7(2):243–252. doi: 10.1016/0022-3468(72)90502-7. [DOI] [PubMed] [Google Scholar]
- Stauffer U. G., Herrmann P. Comparison of late results in patients with corrected intestinal malrotation with and without fixation of the mesentery. J Pediatr Surg. 1980 Feb;15(1):9–12. doi: 10.1016/s0022-3468(80)80393-9. [DOI] [PubMed] [Google Scholar]