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Intestinal malrotation: presentation in the older child

A F Uba1, L B Chirdan, S T Edino

  • 1Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria.

Nigerian Journal of Medicine : Journal of the National Association of Resident Doctors of Nigeria
|April 19, 2005
PubMed

Insights

Diagnosing intestinal malrotation in older children is challenging due to non-specific symptoms. This study highlights key presentations like abdominal pain and vomiting, emphasizing prompt surgical intervention for symptom relief.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Clinical Diagnosis

Background:

  • Intestinal malrotation diagnosis in older children presents challenges due to non-specific symptoms.
  • This study aimed to identify the presentation patterns of intestinal malrotation in Nigerian children.

Purpose of the Study:

  • To determine the characteristic clinical and radiological presentations of intestinal malrotation in older Nigerian children.
  • To evaluate the diagnostic challenges and treatment outcomes for this condition.

Main Methods:

  • Retrospective review of clinical, radiological, and operative records.
  • Study included 9 pediatric patients (aged 2 years and above) diagnosed with malrotation.
  • Data collected from March 1992 to December 2002 at Jos University Teaching Hospital.

Main Results:

  • Common symptoms included intermittent colicky abdominal pain (100%), recurrent vomiting (88.9%), and failure to thrive (44.4%).
  • Preoperative diagnosis was achieved in only 3 patients using barium meal.
  • Surgical findings revealed obstructing bands, partial volvulus, and mesocolic hernias, with prompt symptom relief post-surgery.

Conclusions:

  • Intestinal malrotation should be suspected in children with recurrent abdominal pain, vomiting, or diarrhea, especially with failure to thrive.
  • Early surgical intervention is crucial for satisfactory symptom resolution.
  • The study underscores the importance of considering malrotation in the differential diagnosis of chronic gastrointestinal issues in children.
Abstract

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