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Postoperative Ileus Murine Model
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Intestinal Rotation Abnormalities and Midgut Volvulus.

Jacob C Langer1

  • 1Division of General and Thoracic Surgery, Hospital for Sick Children, University of Toronto, Room 1524, 555 University Avenue, Toronto, Ontario M5G1X8, Canada.

The Surgical Clinics of North America
|November 30, 2016
PubMed
Summary
This summary is machine-generated.

Rotation abnormalities in children can cause obstruction. Prompt diagnosis of midgut volvulus with ischemia is critical for emergency surgery, while non-acute cases require assessment for narrow-based mesentery to ensure excellent outcomes.

Keywords:
Bilious vomitingHeterotaxiaIntestinal obstructionMalrotationNonrotation

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Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Motility Disorders
  • Congenital Malformations

Background:

  • Intestinal rotation abnormalities are congenital conditions affecting the gastrointestinal tract.
  • These abnormalities can range from asymptomatic presentations to life-threatening complications like midgut volvulus.

Purpose of the Study:

  • To outline the clinical approach to diagnosing and managing intestinal rotation abnormalities in pediatric patients.
  • To emphasize the critical distinction between uncomplicated rotation and midgut volvulus with ischemia.

Main Methods:

  • Clinical assessment for signs of obstruction and ischemia.
  • Evaluation for narrow-based small bowel mesentery in non-acute cases.
  • Surgical intervention based on clinical presentation and diagnostic findings.

Main Results:

  • Prompt identification of midgut volvulus with intestinal ischemia mandates emergency laparotomy.
  • Patients without acute illness require evaluation for narrow-based mesentery.
  • Outcomes are generally excellent, barring significant intestinal ischemia from midgut volvulus.

Conclusions:

  • Accurate diagnosis and timely management are crucial for favorable outcomes in pediatric intestinal rotation abnormalities.
  • Distinguishing between emergent and non-emergent presentations guides appropriate clinical action.
  • Early surgical intervention for midgut volvulus prevents intestinal necrosis and improves prognosis.