Intestinal malrotation

Intestinal malrotation is a congenitalanomaly of rotation of the midgutwhere the small bowelis found on the right side of the abdomenand the cecumis found in the subpyloricregion. Since the intestinesare attached by a narrow base, the midgut is prone to twisting (or volvulus), which can obstruct the mesentericvessels and cause intestinal ischemia.

Presentation

Patients present acutely with biliousvomiting, cramping abdominal pain, abdominal distention, and the passage of blood and mucusin their stool. Patients with chronic, uncorrected malrotation will show recurrent abdominal pain and vomiting.

Diagnosis

With acutely ill patients, consider an emergency exploratory laparotomy if there is a high index of suspicion. An upper GI series will demonstrate a gasless abdomen, evidence of intestinal obstruction, and gastricor duodenaldistention.

Treatment

Resuscitate the patient with fluids to stabilize them before correcting the malrotation with surgery.

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It uses material from the http://en.wikipedia.org/wiki/Intestinal+malrotation Wikipedia article Intestinal malrotation.