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Related Experiment Videos

Midgut volvulus. An ever-present threat

J H Seashore1, R J Touloukian

  • 1Department of Surgery, Yale University School of Medicine, New Haven, Conn.

Archives of Pediatrics & Adolescent Medicine
|January 1, 1994
PubMed
Summary
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Infants with malrotation and short-term bilious vomiting are at high risk for midgut volvulus (MGV). Early diagnosis and surgery are crucial for preventing mortality and short-gut syndrome in children with malrotation.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Developmental Biology

Background:

  • Malrotation is a congenital anomaly of intestinal rotation during fetal development.
  • Midgut volvulus (MGV) is a surgical emergency that can occur in children with malrotation, leading to intestinal ischemia.
  • Early diagnosis and intervention are critical to prevent severe complications.

Purpose of the Study:

  • To identify risk factors associated with midgut volvulus (MGV) in pediatric patients with intestinal malrotation.
  • To discover clinical and diagnostic clues for the early identification of MGV in this population.

Main Methods:

  • Retrospective analysis of 68 children who underwent a Ladd operation for malrotation.
  • Data collected on patient age, symptom duration, vomiting characteristics, and diagnostic imaging findings.

Related Experiment Videos

  • Correlation of clinical factors with the presence of MGV at surgery.

    • Main Results:

    • Midgut volvulus (MGV) was present in 40 of 68 patients (59%).
    • Younger age (less than 1 month) and shorter symptom duration (less than 4 days) were significantly associated with MGV.
    • Bilious vomiting was a stronger indicator of MGV than non-bilious vomiting or pain.
    • Upper GI series had limited sensitivity (54%) for diagnosing MGV, despite high accuracy for malrotation.

    Conclusions:

    • Neonates presenting with acute bilious vomiting and malrotation have a high likelihood of concurrent MGV.
    • Older children with chronic, intermittent symptoms also remain at risk for MGV.
    • Prompt surgical intervention is essential due to the unpredictable risk of catastrophic bowel necrosis, mortality, and short-gut syndrome.