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Pediatric Surgery International

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01-06-2019 | Upper Gastrointestinal Series | Original Article

The identification and treatment of intestinal malrotation in older children

Authors: Charlene Dekonenko, Joseph A. Sujka, Katrina Weaver, Susan W. Sharp, Katherine Gonzalez, Shawn D. St. Peter

Published in: Pediatric Surgery International | Issue 6/2019

Abstract

Purpose

Intestinal malrotation is often diagnosed in infancy. The true incidence of malrotation outside of this age is unknown. These patients can present atypically or be asymptomatic and diagnosed incidentally. We evaluate the incidence, clinical presentation, ideal imaging, and intra-operative findings of patients with malrotation over 1 year of age.

Methods

Retrospective review was conducted in patients older than 1 year, treated for malrotation at a single pediatric tertiary care center from 2000 to 2015. Data analyzed included demographics, presentation, imaging, intraoperative findings, and follow-up. Patients predisposed to malrotation were excluded.

Results

246 patients were diagnosed with malrotation, of which 77 patients were older than 1 year of age. The most common presenting symptoms were vomiting (68%) and abdominal pain (57%). The most common method of diagnosis was UGI (61%). In 88%, the UGI revealed malrotation. 73 of 75 were confirmed to have malrotation at surgery. Intra-operatively, 60% were found to have a malrotated intestinal orientation and 33% with a non-rotated orientation. Obstruction was present in 22% with 12% having volvulus. Of those with follow-up, 58% reported alleviation of symptoms.

Conclusion

Despite age malrotation should be on the differential given a variable clinical presentation. UGI should be conducted to allow for prompt diagnosis and surgical intervention.

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Title: The identification and treatment of intestinal malrotation in older children
Authors: Charlene Dekonenko
Joseph A. Sujka
Katrina Weaver
Susan W. Sharp
Katherine Gonzalez
Shawn D. St. Peter
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Keywords: Upper Gastrointestinal Series
Key Symptom
Abdominal Pain
Published in: Pediatric Surgery International / Issue 6/2019
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-019-04454-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The identification and treatment of intestinal malrotation in older children

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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