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Abdominal pain with a twist
Rachael Mathews1, Sam Thenabadu, Thiagarajan Jaiganesh
1Emergency Department, St Georges Hospital-London, Blackshaw Road, Tooting, London, SW17 0QT, UK. jaiganesh@doctors.org.uk.
International Journal of Emergency Medicine
|June 4, 2011
Summary
Intestinal malrotation, a congenital condition, can cause severe issues in infants. Rarely, it presents as chronic abdominal pain in older children and adolescents, requiring physician awareness.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Emergency Medicine
Background:
- Intestinal malrotation results from incomplete fetal midgut rotation during development.
- Typically presents in infancy with acute, life-threatening volvulus and ischemia.
- It is an uncommon cause of abdominal pain in older children and adolescents.
Purpose of the Study:
- To highlight intestinal malrotation as a differential diagnosis for chronic or recurrent abdominal pain in older pediatric populations.
- To increase awareness among emergency physicians regarding this rare presentation.
Main Methods:
- Case presentation of a pediatric patient with malrotation presenting with chronic abdominal pain.
- Review of relevant literature on intestinal malrotation.
Main Results:
- The case illustrates that malrotation can manifest as chronic or recurrent abdominal pain beyond infancy.
- This presentation can be mistaken for other common pediatric abdominal conditions.
Conclusions:
- Intestinal malrotation should be considered in the differential diagnosis of persistent abdominal pain in children and adolescents.
- Emergency physicians must maintain a high index of suspicion for malrotation in non-infantile presentations.
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