Intestinal malrotation presenting outside the neonatal period

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Developmental Biology

Background:

• Intestinal malrotation is a congenital anomaly affecting the gastrointestinal tract.
• Early diagnosis and intervention are crucial for preventing complications.

Purpose of the Study:

• To analyze the clinical presentation, diagnosis, and surgical outcomes of intestinal malrotation in pediatric patients.
• To highlight the importance of considering malrotation in the differential diagnosis of pediatric abdominal symptoms.

Main Methods:

• Retrospective review of 37 pediatric patients treated for intestinal malrotation over five years.
• Diagnosis confirmed using gastrointestinal contrast studies.
• Surgical treatment involved a standard Ladd's procedure.

Main Results:

• Common presenting features included intermittent vomiting, failure to thrive, and recurrent abdominal pain.
• Midgut volvulus occurred in only 14% of patients, contrasting with higher rates in neonates.
• Two deaths were recorded; 94% of survivors showed favorable responses to surgery.
• Nearly half of the patients presented with poor nutritional status.

Conclusions:

• Intestinal malrotation requires prompt diagnosis and surgical management.
• Ladd's procedure is an effective treatment for pediatric intestinal malrotation.
• The condition should be considered in the differential diagnosis for a broad spectrum of pediatric symptoms.