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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
PubMed

Insights

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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