Document Type : case report

Authors

1 Department of Paediatric Surgery. Dr RML Institute of Medical Sciences. Lucknow. UP. India.

2 Department of Paediatric Surgery. Dr RML Institute of Medical Sciences. Lucknow. UP.India

3 Department of Surgery. National Institute of Medical Sciences and Research. Jaipur. India

4 Department of Paediatric Surgery. Dr RML Institute of Medical sciences, Gomtinagar. Lucknow. UP. India

10.22038/ijp.2024.78490.5433

Abstract

Introduction:

Intestinal malrotation is a congenital disorder of the intestine mostly of the neonatal period and infancy. Delayed diagnosis can increase morbidity and cause mortality.

Case 1:

A 5-year-old female had recurrent abdominal pain and vomiting since she was 3 months old. Medications and anti-tubercular treatment failed to improve her condition. Further investigations revealed intestinal malrotation, which was surgically corrected and the patient recovered well.

Case 2:

A 4-year-old girl had a fever, abdominal pain, and vomiting for a month. Surgical exploration revealed a twisted bowel with the appendix on the left side and Polysplenia. Ladd's procedure was done and she recovered well.

Case 3:

A 13-year-old boy with a year-long history of recurrent abdominal pain, bloating, and vomiting was referred to us with constant abdominal pain for 5 days. Radiology showed intestinal malrotation with midgut volvulus. He underwent laparotomy and Ladd's procedure and has recovered well.

Case 4:

A 7-year-old boy was admitted with abdominal pain, vomiting, and constipation. Investigations revealed bowel obstruction with volvulus. Surgery showed a non-viable midgut, where derotation was done to restore viability but failed.

Case 5:

An 11-year-old female presented with obstruction, bilious vomiting, and shock. Urgent laparotomy revealed midgut volvulus with gangrene. Derotation of the gangrenous bowel with peritoneal lavage was performed. Unfortunately, the patient died before re-look laparotomy.

Conclusion:

Intestinal Malrotation should be suspected in children with recurrent abdominal pain, vomiting, and malnutrition. Education surrounding the timely diagnosis of malrotation in the older child is crucial to the attending physicians for early surgical referral to prevent morbidity and mortality.

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