Intestinal malrotation needs immediate consideration and investigation.

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Medical Diagnostics

Background:

• Intestinal malrotation is a congenital anomaly where the intestines fail to rotate properly during fetal development.
• This condition can lead to serious complications, including midgut volvulus, which compromises blood supply to the intestines.

Purpose of the Study:

• To evaluate the clinical presentation, diagnostic methods, and incidence of volvulus in patients with intestinal malrotation.
• To identify unusual clinical clues that may aid in the early diagnosis of this condition.

Main Methods:

• A retrospective descriptive review of patients diagnosed with intestinal malrotation between 2002 and 2014.
• Patients were categorized into two groups: infants (≤1 year) and children (>1 year).
• Data collected included demographics, clinical history, symptoms, physical examination, diagnostic work-up, operative findings, and early outcomes.

Main Results:

• Bilious vomiting was the primary symptom in both infant and older child groups.
• Unusual symptoms in infants included respiratory insufficiency, dehydration, afebrile convulsions, and lethargy.
• In older children, recurrent abdominal pain and feeding intolerance requiring frequent hospitalizations were noted. Midgut volvulus was present in 15 patients.

Conclusions:

• Intestinal malrotation, with or without midgut volvulus, is a significant condition across all age groups.
• Diagnosis can be challenging due to non-specific or unusual presentations, potentially leading to delayed treatment and catastrophic outcomes.
• Prompt diagnosis and surgical management, such as Ladd's procedure, are essential, especially considering the high risk of complications in children over one year of age.