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Intestinal Malrotation

Failure of fetal intestinal rotation carries the risk of volvulus.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Intestinal Malrotation?

Intestinal malrotation is a congenital anomaly resulting from abnormal rotation of the midgut around the superior mesenteric artery (SMA) at 4-12 weeks of fetal life. Its incidence is 1/500 live births.

Malrotation is often accompanied by Ladd bands. These abnormal fibrous bands can compress the duodenum and cause obstruction. The most serious complication is midgut volvulus; the bowel rotated around the SMA loses its blood supply, leading to ischemia and necrosis.

75% of cases become symptomatic in the first month of life; 50% of these in the first week. Bilious vomiting is an early sign and requires emergency evaluation. Treatment is surgical correction with the Ladd procedure.

Symptoms

Bilious vomiting (most important early sign)
Abdominal distension
Peritoneal signs (volvulus)
Bloody stool (ischemia)
Feeding intolerance
Shock (advanced volvulus)

Risk Factors

Congenital diaphragmatic hernia
Omphalocele and gastroschisis
Heterotaxy syndrome
Congenital heart disease
Down syndrome (mild increase)
Intestinal atresia

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Bilious vomiting in newborn (emergency)
  • Sudden abdominal distension
  • Bloody stool
  • Signs of shock
  • Feeding intolerance and lethargy

Treatment Methods

01
Emergency evaluation: upper GI contrast study
02
Diagnosis: 'corkscrew' appearance or Treitz position
03
Emergency surgery: Ladd procedure
04
Volvulus detorsion and division of Ladd bands
05
Appendectomy (due to atypical position)
06
Necrotic bowel resection (if needed)

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.