Intestinal malrotation and volvulus

Malrotation means a malfunction in the rotation of the intestine or a malfunction in its attachment to the back wall of the abdomen. A normal intestine rotates counterclockwise. The superior mesenteric artery acts as the axis of rotation. An unfixed bowel predisposes to volvulus (knotting of the bowel hinge) and obstruction. It is sometimes associated with asplenism or congenital heart defects.

Diagram showing the normal process by which the intestine "rotates" and herniates during development

Clinical picture

• Symptoms of acute or recurrent Acute abdomen appear,
• symptoms are developed shortly after birth or anytime during the first year of life.

Diagnosis

• On the X-ray, we can see the distribution of air - there are no bubbles in the area of the caecum,
• rotation failure is then confirmed by irrigography.

Therapy

• Surgical

Small bowel volvulus

Ladd's bangs - unrotated cecum and duodenal compression by peritoneal bands

Links

Related articles

• Congenital atresias and stenoses of the gastrointestinal tract
  • pylorostenosis congenita
  • superior mesenteric artery syndrome
  • meconium ileus
  • small bowel obstruction
  • megacolon congenitum

Sources

• BENEŠ, Jiří. Studijní materiály [online]. ©2007. [cit. 2010-04]. <http://www.jirben.wz.cz/>.

References

• HRODEK, Otto – VAVŘINEC, Jan, et al. Pediatrie. 1. edition. Praha : Galén, 2002. ISBN 80-7262-178-5.

• ŠAŠINKA, Miroslav – ŠAGÁT, Tibor – KOVÁCS, László. Pediatria. 2. edition. Bratislava. 2007. ISBN 978-80-89171-49-1.