Malrotation of the intestine

Torres, Antoni; Ziegler, Moritz M.

doi:10.1007/bf01658699

Cited by 274 publications

(237 citation statements)

References 33 publications

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“…Disturbance of this process will lead to incomplete or non-rotation of the foetal midgut. This condition affects approximately 1 in 500 live births with the vast majority of the associated complications presenting in the first month of life when its diagnosis is made [1][2][3] . It has been reported that well over 90% of the affected individuals manifest by the time of their first birthday [1][2][3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

“…This condition affects approximately 1 in 500 live births with the vast majority of the associated complications presenting in the first month of life when its diagnosis is made [1][2][3] . It has been reported that well over 90% of the affected individuals manifest by the time of their first birthday [1][2][3][4][5] . The diagnosis of midgut malrotation is rarely reported in adults [2,[4][5][6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

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Recurrent intestinal volvulus in midgut malrotation causing acute bowel obstruction: A case report

Sheikh¹

2013

WJGS

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Intestinal malrotation occurs when there is a disruption in the normal embryological development of the bowel. The majority of patients present with clinical features in childhood, though rarely a first presentation can take place in adulthood. Recurrent bowel obstruction in patients with previous abdominal operation for midgut malrotation is mostly due to adhesions but very few reported cases have been due to recurrent volvulus. We present the case of a 22-year-old gentleman who had laparotomy in childhood for small bowel volvulus and then presented with acute bowel obstruction. Preoperative computerised tomography scan showed small bowel obstruction and features in keeping with midgut malrotation. Emergency laparotomy findings confirmed midgut malrotation with absent appendix, abnormal location of caecum, ascending colon and small bowel. In addition, there were small bowel volvulus and a segment of terminal ileal stricture. Limited right hemicolectomy was performed with excellent postoperative recovery. This case is presented to illustrate a rare occurrence and raise an awareness of the possibility of dreadful recurrent volvulus even several years following an initial Ladd's procedure for midgut malrotation. Therefore, one will need to exercise a high index of suspicion and this becomes very crucial in order to ensure prompt surgical intervention and thereby preventing an attendant bowel ischaemia with its associated high fatality.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recurrent intestinal volvulus in midgut malrotation causing acute bowel obstruction: A case report

Sheikh¹

2013

WJGS

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“…This condition most commonly presents during the first year of life and has high rates of morbidity and mortality [1,2] . Midgut volvulus without malrotation is an extremely rare surgical condition, which may also occur during gestation [3][4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Intrauterine midgut volvulus without malrotation: Diagnosis from the ‘coffee bean sign’

Park

Jae²,

Kim³

et al. 2008

WJG

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Fetal midgut volvulus is quite rare, and most cases are associated with abnormalities of intestinal rotation or fixation. We report a case of midgut volvulus without malrotation, associated with a meconium pellet, during the gestation period. This 2.79 kg, 33-wk infant was born via a spontaneous vaginal delivery caused by preterm labor. Prenatal ultrasound showed dilated bowel loops with the appearance of a 'coffee bean sign'. This patient had an unusual presentation with a distended abdomen showing skin discoloration. An emergency laparotomy revealed a midgut volvulus and a twisted small bowel, caused by complicated meconium ileus. Such nonspecific prenatal radiological signs and a low index of suspicion of a volvulus during gestation might delay appropriate surgical management and result in ischemic necrosis of the bowel. Preterm labor, specific prenatal sonographic findings (for example, the coffee bean sign) and bluish discoloration of the abdominal wall could suggest intrauterine midgut volvulus requiring prompt surgical intervention.

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“…In another study performed in 2008 in America, although high sensitivity of GI series evaluation was confirmed in the detection of intestinal malrotation, this method did not have proper specificity and diagnostic value (18). In a study performed by Torres et al 95% sensitivity and 86% specificity was reported for upper GI series in malrotation diagnosis (19). Table 3 shows sensitivity and specificity of upper GI series and ultrasound in some studies.…”

Section: Discussionmentioning

confidence: 98%

Diagnostic Value of Ultrasound and Gastrointestinal Series Findings in Detection of Pediatric Intestinal Malrotation

2018

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Background: Clinical diagnosis of malrotation is difficult to achieve, especially in older children and adults as its nonspecific presentations at this stage are usually neglected leading to delayed diagnosis of these cases. Objectives: In this study, we aimed to evaluate the diagnostic values of ultrasound and upper gastrointestinal (GI) series in patients with suspected intestinal malrotation. Methods: This six-year cross-sectional, prospective study was conducted in Dr. Sheikh Children's Hospital affiliated to Mashhad University of Medical Sciences, Mashhad, Iran from 2009 to 2015. Totally, 67 children (aged < 15 years) with clinical findings of intestinal malrotation who had evidence of malrotation in ultrasound or upper GI series were enrolled in the study. Results of radiological evaluation were compared to the final diagnosis of patients achieved from surgery. Data analysis was performed using SPSS software. Results: Of the 67 enrolled participants with clinical findings or suspected radiological signs of intestinal malrotation, about half (52.2%) were male. Patients were 2 days to 16 years (mean, 2.5 years) old. Associated anomalies were observed in 47.7% of cases. Sensitivity and specificity were 82.5% and 85.7%, respectively for GI series findings and 82.3% and 54.5%, respectively for ultrasound compared with surgical findings as a gold standard. Conclusions: Ultrasound has a similar diagnostic value compared to upper GI series. They are complementary examinations and negative ultrasound or GI series results do not necessarily rule out intestinal malrotation. Mesenteric vessels ultrasound could be used as an accurate diagnostic method for the detection of intestinal rotational disorders.

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Malrotation of the intestine

Cited by 274 publications

References 33 publications

Recurrent intestinal volvulus in midgut malrotation causing acute bowel obstruction: A case report

Recurrent intestinal volvulus in midgut malrotation causing acute bowel obstruction: A case report

Intrauterine midgut volvulus without malrotation: Diagnosis from the ‘coffee bean sign’

Diagnostic Value of Ultrasound and Gastrointestinal Series Findings in Detection of Pediatric Intestinal Malrotation

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