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Late presentations of midgut malrotation in children
Insights
Intestinal malrotation can cause varied symptoms in older children, including chronic abdominal pain and vomiting. Early diagnosis and surgical treatment are crucial for a cure.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intestinal malrotation is a congenital anomaly that can lead to significant gastrointestinal issues.
- While often diagnosed in infancy, malrotation can present atypically in older children.
Observation:
- Older children with intestinal malrotation may exhibit acute symptoms mimicking duodenal obstruction (less than 72 hours).
- More commonly, symptoms include chronic abdominal pain, vomiting, or diarrhea.
- Consider malrotation in pediatric patients with intermittent abdominal pain, vomiting, diarrhea, or malabsorption.
Findings:
- Intestinal malrotation presents with diverse clinical manifestations in older children.
- Atypical presentations are common, ranging from acute obstruction to chronic gastrointestinal disturbances.
Implications:
- Prompt diagnosis of intestinal malrotation is essential for effective management.
- Surgical intervention offers a curative solution for symptomatic intestinal malrotation.
- Early surgical treatment improves outcomes and prevents long-term complications.
Abstract:
Malrotation of the intestine may become symptomatic in the older child and may manifest itself in atypical presentations. Older children may present with symptoms of less than 72 hours duration which are typical of acute duodenal obstruction. More frequently, however, the older child with malrotation will present with chronic abdominal pain with or without vomiting or chronic diarrhea. The diagnosis of malrotation should be considered in any child with intermittent abdominal pain, vomiting, diarrhea, or malabsorption. Surgical intervention is curative and should be implemented as soon as possible after the diagnosis is made.