Related Experiment Videos
[Disorders of intestinal rotation and fixation in older children]
M Králová1, J Koudelka, J Preis
1Oddĕlení dĕtské chirurgie FN, Hradec Králové.
Insights
This study reviews five older children diagnosed with malrotation of the gut, a congenital condition. Early diagnosis through clinical symptoms, imaging, or incidental findings is crucial for effective management.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Abnormalities
Background:
- Intestinal malrotation is a congenital anomaly that can lead to significant gastrointestinal issues.
- Diagnosis in older children is less common and often presents with varied clinical manifestations.
- Prompt identification is essential to prevent complications such as obstruction or volvulus.
Purpose of the Study:
- To analyze the diagnostic methods and outcomes of malrotation of the gut in a cohort of older children.
- To highlight the importance of considering malrotation in pediatric patients presenting with abdominal symptoms.
- To review associated anomalies and surgical interventions for intestinal malrotation.
Main Methods:
- Retrospective case series of five pediatric patients diagnosed with intestinal malrotation.
- Review of clinical presentations, diagnostic imaging (e.g., upper GI series, CT scans), and operative findings.
- Analysis of surgical procedures performed, including Ladd's procedure and hernia repair.
Main Results:
- Malrotation was diagnosed in five children aged 3 to 16 years.
- Three cases were diagnosed based on clinical symptoms and imaging; two were incidental findings during surgery.
- Associated conditions included left-sided paraduodenal hernia (two cases) and external duodenal stenosis by Ladd's bands (one case).
- Two surgically detected cases involved complete non-rotation.
Conclusions:
- Intestinal malrotation can present in older children, necessitating a high index of suspicion.
- Diagnostic approaches should integrate clinical evaluation, advanced imaging, and intraoperative findings.
- Timely surgical intervention is critical for managing malrotation and associated anomalies in pediatric patients.
Abstract:
The authors discuss five older children where malrotation of the gut was diagnosed. The youngest child was three years old, the oldest 16 years. In three children the malrotation was diagnosed from clinical symptoms and examination by imaging methods, in two it was detected by chance during operation. In the two children where the impaired rotation of the gut was detected on operation, non-rotation was involved. In the remaining three children twice a left side paraduodenal hernia was diagnosed and once an external stenosis of the duodenum by Ladd's bands.