Intestinal malrotation: presentation in the older child

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.