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[Intestinal malrotation in children]
A Fernández Sánchez1, P López Pereira, J A Díez Pardo
1Hospital Infantil La Paz, Departamento de Cirugía Pediátrica, Facultad de Medicina de la Universidad Autónoma de Madrid.
Insights
Intestinal malrotation, often overlooked, presents varied symptoms. This study details 33 pediatric cases, highlighting midgut volvulus and intestinal obstruction as common complications, with an 85% survival rate.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Developmental Biology
Context:
- Intestinal malrotation is underrepresented in Spanish medical literature.
- Variable clinical presentations can lead to delayed diagnosis in infants and children.
- This report reviews a significant cohort of pediatric cases.
Purpose:
- To analyze the clinical presentation, complications, and outcomes of intestinal malrotation in pediatric patients.
- To highlight the importance of early diagnosis and surgical intervention.
- To contribute to the understanding of this condition in a specific geographic context.
Summary:
- The study reviewed 33 pediatric patients (1 week to 8 years) surgically treated for intestinal malrotation between 1965 and 1985.
- Midgut volvulus (50%) and intestinal obstruction (especially in neonates) were the most frequent complications and presentations.
- Associated malformations occurred in 30% of patients, and were present in all non-survivors. Long-term survival was 85%.
Impact:
- Emphasizes the critical need for increased awareness and timely diagnosis of intestinal malrotation in pediatric populations.
- Provides valuable data on surgical outcomes and associated risks, informing clinical practice.
- Underscores the link between associated anomalies and patient prognosis.
Abstract:
Intestinal malrotation has received, so far, little attention in the Spanish medical literature. This is probably due to the fact that is variable forms of clinical presentation may be overlooked during infancy and childhood and be present or not later in adult life. This is a report on 33 patients between 1 week and 8 years old operated upon, from 1965 to 1985, at the Clinica Infantil "La Paz", Madrid, with pre or postoperative diagnoses of intestinal malrotation (patients with Bochdalek's hernia, omphalocele and gastrosschisis are excluded). Midgut volvulus has been the most frequent preoperative complication and has occurred in 50% of patients. Intestinal obstruction was the most frequent clinical presentation, specially in patients under one week of age. There was a 30% figure of associated malformations, mostly of the duodenojejunal area (atresia, diaphragm, anular pancreas). All 5 deceased patients had other associated malformations. Long term survival was 85%.