Ladd's Syndrome - unrotated cecum and duodenal compression by peritoneal bands.It belongs to the so-called proximal intestinal obstructions - these are characterized by - minor distension of the abdomen and permanent explosive vomiting.
In the case of intestinal obstruction below the level of 15 cm from the beginning of the jejunum - the so-called distal obstruction - bloating, distension of the abdomen dominates, vomiting comes later.
Obstruction of the duodenum can be caused by atresia (more often) or stenosis.
It is more common in Down syndrome and in immature children.
The obstruction is usually located below the major papilla of the duodenum.
Otherwise, obstruction can also occur with incomplete rotation of the intestine, volvulus congenitalis, with pancreas annulare.
Clinical picture:
Obstruction of the duodenum is closely related to the circulation of amniotic fluid - in all cases of obstruction, polyhydramnios is detected during childbirth .
Therefore, every time polyhydramnios is found, we have to aspirate the stomach contents with a tube after birth - and if it is more than 15 ml, we suspect proximal intestinal obstruction.
The main symptom – projectile vomiting (with atresia it starts immediately after birth, with stenosis after several hours).
Vomit is a yellowish admixture of bile.
Sometimes we see a peristaltic wave similar to that of pylorostenosis.
Laboratory – hypochloremic alkalosis, Na + and K + depletion;
with excessive vomiting of intestinal contents, MAl can pass into MAC and the disruption of the environment is further aggravated.
Diagnosis - ultrasound can be detected already intrauterine.
After birth, the best native x-ray image of the abdomen in the hanging position (the contrast material is air swallowed by the baby) at the time of birth.
