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Intestinal malrotation in Trinidad
1Department of Surgery, Faculty of Medical Sciences, University of the West Indies, Mount Hope, Trinidad.
Insights
Malrotation of the intestines in children under 10 presents serious risks, with early symptoms including vomiting and malnutrition. This condition in infants requires prompt diagnosis and surgical care to reduce high morbidity and mortality rates.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Malrotation of the intestines is a congenital condition that can lead to significant gastrointestinal issues in infants.
- Early diagnosis and intervention are critical for managing complications associated with intestinal malrotation.
Purpose of the Study:
- To analyze the clinical presentation, diagnostic methods, and outcomes of intestinal malrotation in children under 10 years old.
- To highlight the challenges in surgical care and associated morbidity and mortality rates.
Main Methods:
- Retrospective analysis of medical records for 51 children diagnosed with intestinal malrotation.
- Focus on 20 cases where malrotation was the primary diagnosis, examining age at presentation, symptoms, and diagnostic approaches.
Main Results:
- Half of the primary cases presented within the first month of life, with universal vomiting and frequent malnutrition.
- Radiological investigations were key diagnostic tools, identifying malrotation in most cases.
- 35% of cases involved volvulus, but no resections were required; however, morbidity and a 15% mortality rate were observed.
Conclusions:
- Intestinal malrotation in young children is associated with severe symptoms and requires vigilant management.
- Prompt diagnosis and appropriate surgical intervention are crucial to improve outcomes and reduce mortality in affected infants.
Abstract:
Fifty-one children under the age of 10 years admitted to a general hospital in Trinidad had a confirmed diagnosis of malrotation of the intestines. This was the primary diagnosis in 20 cases. Analysis of the records of these 20 revealed that one-half were less than 1 month of age at first presentation. Vomiting was a universal complaint, and nearly two-thirds were malnourished. Disturbed bowel habit, anorexia and abdominal pain were also reported. In 30% (six of 20) there were signs of dehydration; an equal number had features of intestinal obstruction. Radiological investigation provided the diagnosis in all but one child, who underwent surgical exploration with a provisional diagnosis of appendicitis. Although a volvulus was found in 35% of cases, no resections were necessary. A high rate of morbidity and a mortality rate of 15% highlight the problems involved in the surgical care of young infants.