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Related Experiment Videos

Malrotation of bowel: variable patterns with different surgical considerations

W L Schey1, J S Donaldson, J R Sty

  • 1Department of Diagnostic Radiology, Michael Reese Hospital & Medical Center, Chicago, IL 60616.

Journal of Pediatric Surgery
|January 1, 1993
PubMed
Summary

This study categorizes bowel malrotation patterns based on radiographic findings. The position of the ligament of Treitz and cecum helps predict patient prognosis.

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Area of Science:

  • Medical Imaging
  • Surgical Anatomy
  • Pediatric Surgery

Background:

  • Intestinal malrotation is a congenital anomaly with diverse clinical presentations.
  • Accurate diagnosis and prognosis are crucial for effective management.
  • Existing classification systems may not fully capture the spectrum of malrotation patterns.

Purpose of the Study:

  • To categorize varied roentgenographic patterns of intestinal malrotation.
  • To develop a prognostic system based on radiographic findings.
  • To correlate radiographic patterns with clinical, surgical, and prognostic outcomes.

Main Methods:

  • Review of 53 patient records with malrotation.
  • Classification of roentgenographic patterns into categories A-Infantile (AI), A-Adult (Aa), B, C, and D.

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  • Barium gastrointestinal examination to assess ligament of Treitz and cecum position.
  • Literature review for supporting or contradictory data.

    • Main Results:

    • Distinct clinical, radiographic, and surgical differences were observed among the categorized malrotation patterns.
    • The presence and/or position of the ligament of Treitz and cecum provided prognostic insights.
    • The developed prognostic scheme demonstrated reliability.

    Conclusions:

    • A novel classification system for malrotation patterns is proposed.
    • Radiographic assessment of ligament of Treitz and cecum offers valuable prognostic information.
    • This system aids in determining patient prognosis for varied bowel malrotation.