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Intestinal malrotation without volvulus in infancy and childhood
Summary
Diagnosing intestinal malrotation in children can be challenging due to subtle symptoms. Surgical intervention is recommended for symptomatic cases, offering long-term relief for most patients.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Diagnostic Imaging
Background:
- Intestinal malrotation without volvulus presents with non-specific symptoms like failure to thrive and intermittent bilious vomiting.
- Diagnosis can be challenging compared to presentations with acute volvulus.
- Plain abdominal X-rays may reveal a
- double bubble sign
- while barium studies are definitive.
Purpose of the Study:
- To evaluate the diagnostic challenges and long-term outcomes of surgically managed intestinal malrotation in pediatric patients.
- To assess the efficacy of surgical intervention for symptomatic intestinal malrotation.
Main Methods:
- Retrospective follow-up study of 18 pediatric patients diagnosed with intestinal malrotation.
- Review of diagnostic methods including plain radiography and barium meal studies.
- Analysis of surgical outcomes and symptom resolution post-intervention.
Main Results:
- 14 out of 18 patients underwent surgical correction for intestinal malrotation.
- A significant majority (17 out of 18) experienced symptom resolution.
- Median follow-up duration was 205 months, demonstrating sustained positive outcomes.
Conclusions:
- Symptomatic intestinal malrotation in children warrants surgical consideration.
- Surgical treatment offers a high success rate and long-term symptom relief for most patients.
- Mobile caecum may represent an exception where conservative management might be considered.