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Intestinal malrotation is a congenital anomaly of rotation of the midgut (embryologically, the gut undergoes a complex rotation outside the abdomen). As a result:
Additional recommended knowledge
This can lead to a number of disease manifestations such as:
The exact causes are not known. It is not associated with a particular gene, but there is some evidence of recurrence in families.
Patients (often infants) present acutely with midgut volvulus, manifested by bilious vomiting, crampy abdominal pain, abdominal distention, and the passage of blood and mucus in their stool. Patients with chronic, uncorrected malrotation can have recurrent abdominal pain and vomiting.
Malrotation can also be entirely asymptomatic.
With acutely ill patients, consider emergency surgery laparotomy if there is a high index of suspicion.
Plain radiography may demonstrate signs of duodenal obstruction with dilatation of the proximal duodenum and stomach but it is often non-specific. Upper gastrointestinal series is the modality of choice for the evaluation of malrotation as it will show an abnormal position of the duodeno-jejunal flexure (ligament of Treitz). In cases of malrotation complicated with volvulus, it demonstrates a corkscrew appearance of the distal duodenum and jejunum. In cases of obstructing Ladd bands, it will reveal a duodenal obstruction.
It is usually discovered near birth, but in some cases is is not discovered until adulthood. In adults, the "whirlpool sign" of the superior mesenteric artery can be useful in identifying malrotation.
Resuscitate the patient with fluids to stabilize them before surgically
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Intestinal_malrotation". A list of authors is available in Wikipedia.|