Is There a Need for Bowel Management after Surgery for Isolated Intestinal Malrotation in Children?

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Clinical Outcomes Research

Background:

• Intestinal malrotation is a congenital anomaly requiring surgical correction.
• Long-term morbidity after surgical repair, particularly constipation, is not well-documented.

Purpose of the Study:

• To determine the incidence of constipation in children following Ladd's procedure for isolated intestinal malrotation.

Main Methods:

• Retrospective analysis of children (<15 years) undergoing Ladd's procedure (2001-2016).
• Data collected included demographics, perioperative volvulus, bowel resection, short-term/long-term complications.
• Constipation defined as laxative use at 1-year follow-up.

Main Results:

• 43 children included; 23.7% developed constipation at 1-year follow-up.
• 60.5% experienced perioperative volvulus; 9.3% required bowel resection.
• 30.2% had short-term complications; 11.6% needed re-operation.

Conclusions:

• Constipation is a significant long-term issue for children after Ladd's procedure.
• Thorough bowel function evaluation is crucial during follow-up.
• Persistent constipation warrants investigation for dysmotility or neuronal dysplasia.