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Intestinal malrotation in neonates with nonbilious emesis.
K El-Chammas1, W Malcolm, A M Gaca
1Department of Pediatrics, American University of Beirut Medical Center, Beirut, Lebanon.
Summary
Intestinal malrotation can present subtly in newborns as nonbilious vomiting, mimicking common gastroesophageal reflux. Early diagnosis is crucial for timely surgical intervention and improved outcomes in this uncommon condition.
Area of Science:
- Pediatric Surgery
- Neonatal Medicine
- Surgical Gastroenterology
Background:
- Intestinal malrotation is a congenital anomaly with varied clinical presentations.
- Prompt diagnosis and surgical intervention are key to optimizing patient outcomes.
- Bile-stained emesis is the most common sign of malrotation in neonates.
Observation:
- This report details three neonates with unsuspected intestinal malrotation.
- These infants presented with nonbilious emesis, initially diagnosed as gastroesophageal reflux or aspiration.
- Gastroesophageal reflux can be a deceptive initial symptom of malrotation.
Findings:
- Malrotation was diagnosed in neonates presenting with nonbilious vomiting, mimicking reflux.
- The study highlights that nonbilious emesis can be a sign of intestinal malrotation.
- Persistent or severe reflux symptoms in infants warrant consideration of malrotation.
Implications:
- Clinicians must consider intestinal malrotation in neonates with persistent or severe gastroesophageal reflux symptoms.
- Recognizing subtle presentations of malrotation can lead to earlier diagnosis and treatment.
- This underscores the importance of a broad differential diagnosis in neonatal vomiting.