Post- infantile presentation of intestinal malrotation
KMJ-Kuwait Medical Journal. 2011; 43 (4): 281-286
in English
| IMEMR
| ID: emr-118226
ABSTRACT
To study intestinal malrotation presenting after the age of one year, analyze the spectrum of presentations and to predict risk of volvulus. Retrospective study. Zagazig University Hospitals [Egypt] and King Fahd Hospital, Saudi Arabia. All cases [54] of malrotation during April 2006 to April 2010. Analysis of clinical, radiological and operative data. Presentation, significant associations and risk of volvulus. The mean age was 4.8 +/- 2.13 years. Presentations included acute volvulus [n = 27, 50%], chronic volvulus [4, 7.5%], mesocolic hernia [4, 7.5%], intussusception [5, 9%], exomphalos [5, 9%] and non-specific presentation [9, 17%]. Associated anomalies were found in 19 cases [35%] with significant association of chronic volvulus and exomphalos. Typical anatomical malrotation was seen in 21 [39%] cases with significant risk of volvulus [odds ratio 9.2]. Nausea and vomiting, abdominal colic, and malnutrition were dominant in acute and chronic volvulus, mesocolic hernia and intussusception [p < 0.05]. Malnutrition and gastroesophageal reflux disease [GERD] were significantly associated with chronic volvulus [p < 0.05]. Duodenal obstruction was significantly evident in acute volvulus while high cecum was dominant in intussusception. Prolonged ileus and persistent symptoms were significant in chronic volvulus and mesocolic hernia [p < 0.05], while wound infection and short bowel syndrome were significant in acute volvulus. Malrotation in the post-infantile period has a wide spectrum and non-specific presentation. Risk of midgut volvulus is present, especially in typical cases, and trials must be done to predict the risk and avoid unnecessary surgery
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Index:
IMEMR (Eastern Mediterranean)
Main subject:
Intestinal Volvulus
/
Hernia, Umbilical
/
Intestines
/
Intussusception
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Language:
English
Journal:
Kuwait Med. J.
Year:
2011
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