A Clinical Review of Symptomatic Intestinal Malrotation

Cho, Yong Hoon; Kim, Hae Young

Abstract

PURPOSE: Intestinal malrotation can have variable clinical presentations, and is a disease that may cause bilious vomiting. This study was performed to analyze the clinical characteristics of patients with symptomatic intestinal malrotation.
METHODS
From Jan 2001 to Dec 2005, 11 cases of malrotation, receiving surgical procedure, and were retrospectively reviewed for their clinical characteristics.
RESULTS
There were 8 male (72.7%) and 3 female (27.3%) patients. At the time of the operation, 10 patients (90.9%) were in the neonatal period. According to the clinical manifestations, bilious vomiting was seen in all cases (100%), with other symptoms (fever, lethargy and abdominal distention) observed in certain cases. Of the several diagnostic tools available, abdominal sonography and UGI series showed sensitivities of 100%. According to the operative findings, 6 cases (54.5%) had malrotation only, with the other 5 (45.5%) having additional midgut volvulus. The Ladd procedure was routinely performed in all cases, with additional detorsion or bowel resection performed in the cases of malrotation with midgut volvulus. After a definite procedure, an adhesive intestinal obstruction developed in 3 cases (27.3%), with surgical correction for the obstruction performed in one case. There were no cases of mortality.
CONCLUSION
Intestinal malrotation could be of preferential concern for those neonates presenting with bilious vomiting. The proper diagnosis, via abdominal sonography, and early surgical management for intestinal malrotation will show a good result.