Anomalies of intestinal rotation in childhood

Analysis of 447 cases

Frederick Rescorla, F. J. Shedd, J. L. Grosfeld, D. W. Vane, K. W. West

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

This report concerns 447 infants and children with anomalies of rotation and fixation. Patients were placed in four groups based on initial symptoms. Group A involved 18 patients with acute midgut volvulus. At laparotomy, midgut volvulus was noted and reduction of midgut volvulus and a Ladd procedure were performed in 10 cases and resection was required in 8. There were five deaths (28%). Group B included 54 children with chronic symptoms of intermittent volvulus or duodenal obstruction. Group C involved 44 cases of malrotation observed during exploration for other disorders. Patients in groups B and C underwent a Ladd procedure and appendectomy. There were five unrelated deaths. Group D included 331 neonates with malrotation caused by either diaphragmatic hernia (n = 111) or abdominal wall defects (n = 220). A Ladd procedure was performed on 48 patients with abdominal wall defects and 29 surviving children with diaphragmatic hernia. Only 2 of 172 (1.2%) patients with abdominal wall defects and 1 of 34 (29%) patients with diaphragmatic hernia not treated for malrotation had midgut volvulus. Midgut volvulus is more common in infants and is associated with a high mortality rate (28%). Patients with malrotation and chronic obstructive symptoms or those observed during other elective procedures should undergo a Ladd procedure because of the risk of midgut volvulus. The risk of midgut volvulus is low in patients with abdominal wall defects and, probably as a result of adhesions from previous neonatal operations.

Original languageEnglish
Pages (from-to)710-716
Number of pages7
JournalSurgery
Volume108
Issue number4
StatePublished - 1990

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Abdominal Wall
Diaphragmatic Hernia
Duodenal Obstruction
Intestinal Volvulus
Appendectomy
Volvulus Of Midgut
Laparotomy
Newborn Infant
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Rescorla, F., Shedd, F. J., Grosfeld, J. L., Vane, D. W., & West, K. W. (1990). Anomalies of intestinal rotation in childhood: Analysis of 447 cases. Surgery, 108(4), 710-716.

Anomalies of intestinal rotation in childhood : Analysis of 447 cases. / Rescorla, Frederick; Shedd, F. J.; Grosfeld, J. L.; Vane, D. W.; West, K. W.

In: Surgery, Vol. 108, No. 4, 1990, p. 710-716.

Research output: Contribution to journalArticle

Rescorla, F, Shedd, FJ, Grosfeld, JL, Vane, DW & West, KW 1990, 'Anomalies of intestinal rotation in childhood: Analysis of 447 cases', Surgery, vol. 108, no. 4, pp. 710-716.
Rescorla F, Shedd FJ, Grosfeld JL, Vane DW, West KW. Anomalies of intestinal rotation in childhood: Analysis of 447 cases. Surgery. 1990;108(4):710-716.
Rescorla, Frederick ; Shedd, F. J. ; Grosfeld, J. L. ; Vane, D. W. ; West, K. W. / Anomalies of intestinal rotation in childhood : Analysis of 447 cases. In: Surgery. 1990 ; Vol. 108, No. 4. pp. 710-716.
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