Clinical management of intestinal malrotation in different age groups
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In brief
In brief
This retrospective study of 45 pediatric patients examines the diagnosis and surgical management of intestinal malrotation across different age groups. All patients underwent the Ladd procedure, with some requiring bowel resection for volvulus-related necrosis. The study highlights the critical importance of early diagnosis and careful postoperative monitoring to prevent life-threatening complications in this challenging pediatric condition.
- Intestinal malrotation presents with acute abdomen or chronic pain/vomiting; high index of suspicion needed across all pediatric ages.
- Upper GI contrast studies and abdominal ultrasound are key diagnostic tools for confirming malrotation before surgery.
- Ladd procedure is the standard surgical treatment; necrotic bowel resection may be required if volvulus has occurred.
- Male patients are more commonly affected (68.8%); presentation ranges from neonatal period to adolescence (1 day-15 years).
- Rigorous postoperative follow-up is essential to detect complications, especially in neonates and patients with bowel necrosis.
Written by the GCMD Library team from the article.
Abstract
Purpose
Intestinal malrotation, characterized by abnormal intestinal positioning, can lead to severe complications like volvulus and internal hernias, especially in neonates and children. Our aim was to evaluate the diagnostic methods, treatment results and postoperative follow-up of pediatric patients treated for intestinal malrotation.
Methods
This retrospective study reviewed medical records of pediatric patients who underwent surgery for intestinal malrotation between January 2013 and January 2022. Data on demographics, symptoms, diagnostic approaches, surgical interventions, and postoperative outcomes were analyzed.
Results
The study included 45 patients, with a male predominance (68.8%). Ages ranged from 1 day to 15 years, averaging 1.54 years. Presenting symptoms were acute abdomen (n = 21) and chronic abdominal pain with vomiting (n = 24). Diagnoses were established via physical exams and imaging, including upper gastrointestinal contrast studies and abdominal ultrasonography. All patients received the Ladd procedure, with some requiring necrotic bowel resection due to volvulus.
Conclusion
The diagnosis and management of pediatric intestinal malrotation present significant challenges due to its variable symptoms and potential for life-threatening complications. Early and accurate diagnosis, followed by appropriate surgical management, is crucial. This study emphasizes the importance of diligent postoperative follow-up to identify and mitigate complications, particularly in younger and severely affected patients.