Intestinal Malrotation
last authored: Oct 2009, Dave LaPierre
last reviewed:
Introduction
Malrotation occurs in 1:500 infants, occurring within the first two months of life in 80% of cases.
The Case of...
a simple case introducing clincial presentation and calling for a differential diagnosis. To get students thinking.
Causes and Risk Factors
Pathophysiology
Vomiting follows volvulus and bands across the duodenum.
Signs and Symptoms
- history
- physical exam
History
Three presentations are common:
- recurrent vomiting, with intermittent bilious contents
- failure to thrive, with vomiting
- sudden onset abdominal pain, followed by shock
Physical Exam
A distended abdomen is usually present.
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Abdominal ultrasound and/or upper GI series are commonly used.
Differential Diagnosis
Treatments
NG decompression, followed by surgery, is required for malrotation.
Consequences and Course
Volvulus can result in perforation, peritonitis, and death.
Resources and References
Topic Development
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