Related Experiment Video
Updated: Mar 15, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Malrotation in infancy and childhood
Felicity Arthur1, Robert Carachi2
1Department of Paediatric Surgery, Royal Hospital for Sick Children, Glasgow, UK arthurfelicity@gmail.com.
Insights
Diagnosing intestinal malrotation in older children is challenging. This study found chronic abdominal pain and non-bilious vomiting are common signs, necessitating increased awareness for earlier intervention.
Area of Science:
- Pediatric surgery
- Gastrointestinal surgery
- Congenital anomalies
Background:
- Intestinal malrotation with midgut volvulus is a critical neonatal surgical emergency.
- Classic symptoms like bilious vomiting are often absent in older children, delaying diagnosis.
- Delayed diagnosis in older children leads to poorer outcomes.
Purpose of the Study:
- To identify common presenting features of intestinal malrotation in children over 28 days old.
- To improve early diagnosis and outcomes for post-neonatal intestinal malrotation.
- To highlight the need for increased diagnostic awareness in this age group.
Main Methods:
- Retrospective review of children over 28 days old who underwent Ladd's procedure for malrotation.
- Study period: 1998-2014 at Royal Hospital for Sick Children, Glasgow.
- Analysis of presenting complaints, diagnostic time, intraoperative findings, and outcomes.
Main Results:
- Children aged 28 days to 15 years often present with chronic abdominal pain and non-bilious vomiting.
- These symptoms differ from typical neonatal presentations.
- A significant complication rate was observed in this age group.
Conclusions:
- Timely diagnosis of intestinal malrotation in post-neonatal children is crucial.
- Education on recognizing atypical presentations is vital for healthcare providers.
- Earlier diagnosis can lead to improved patient outcomes.
Background And Aims:
The cardinal features of bilious vomiting and abdominal distension assist in the diagnosis of malrotation and volvulus, an often fatal condition in the neonate. When these symptoms are absent, however, diagnosis becomes trickier. In the older child, these classic symptoms are less likely to occur, or occur at a later stage, meaning these children suffer from a delay in diagnosis and consequently do poorer. There is a need, therefore, to identify the common presenting features in these older children in order to facilitate earlier diagnosis and improve outcomes.
Methods:
We reviewed the current literature (Appendix 1) and then undertook a retrospective study in our own department to explore the presenting complaint, time to diagnosis, intraoperative findings and outcome of all children over the age of 28 days who underwent a Ladd's procedure for malrotation at Royal Hospital for Sick Children, Glasgow (RHSC) between 1998 and 2014.
Results:
It was found that children between the ages of 28 days and 15 years are more likely to display signs and symptoms such as chronic abdominal pain and non-bilious vomiting. Their complication rate was found to be significant.
Conclusion:
Education surrounding the timely diagnosis of malrotation in the post-neonatal child is crucial.
Related Concept Videos
01:20Gastrointestinal Motility Disorders
00:51Anatomical Movements
Here are some common anatomical movements:
Flexion and extension motions are in the sagittal (anterior–posterior) plane of motion. These movements take place at the shoulder, hip, elbow, knee, wrist,...
01:20Inborn Errors of Metabolism
01:30Neurulation
01:14Piaget's Stage 1 of Cognitive Development
Exploration...
01:30Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...