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Malrotation: the postoperative period

R Feitz1, A Vos

  • 1The Pediatric Surgical Center Amsterdam, Department of Pediatric Surgery, Academic Hospital of the Free University of Amsterdam, and Emmakinderziekenhuis/Kinder AMC, The Netherlands.

Journal of Pediatric Surgery
|October 6, 1997
PubMed
Summary
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Ladd's procedure can delay bowel function recovery in children, especially when midgut volvulus is present. Early intervention with central venous lines for feeding is recommended for volvulus cases.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Motility Disorders

Background:

  • Persistent gastrointestinal symptoms are reported post-Ladd's procedure.
  • Delayed return of bowel function is a common complication.

Purpose of the Study:

  • To investigate factors influencing postoperative bowel function after Ladd's procedure in children.
  • To compare outcomes between different age groups and the presence of midgut volvulus.

Main Methods:

  • Retrospective study of 57 children undergoing Ladd's procedure (1981-1994).
  • Exclusion criteria: abdominal wall defects, congenital diaphragmatic hernia, duodenal atresia.
  • Patients divided into two age groups: <1 year and ≥1 year.

Main Results:

  • Younger children (<1 year) required longer nasogastric tube decompression (6.7 days vs. 4.3 days).

Related Experiment Videos

  • Midgut volvulus significantly delayed postoperative bowel function resumption (8.6 days vs. 5.1 days).

    • Conclusions:

    • Midgut volvulus is a key factor in delayed bowel function post-Ladd's procedure.
    • Recommend central venous line insertion for feeding in patients with intraoperative volvulus.