Intestinal Malrotation: Experience with Diagnosis And Management of 76 Patients from A Tertiary Care Centre in India
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 9
Abstract
Introduction: Malrotation is a spectrum of anatomical abnormalities due to incomplete rotation and fixation of intestine during the embryonic development. The clinical presentation varies from off and on symptoms of high intestinal obstruction to life threatening mid gut volvulus with intestinal gangrene. The present paper shares our experience with presentation and subsequent management in patients presenting with a diagnosis of intestinal malrotation. Materials and methods: The study was carried out in the department of surgery, SGRRIMHS Dehradun, India. All the patients admitted to the department during last seven years (2010-2017) with a diagnosis of intestinal malrotation were retrospectively analyzed. The case records were looked for the age sex and symptoms at the time of presentation. The data sheets were analyzed for the investigations done and treatment offered and the complications if any with outcome achieved. Results: A total of 76 patients admitted with a diagnosis of intestinal malrotation in the study period. There were 43 males and 33 females. The age at presentation ranged from newborn to 14 year. Most of the patients of intestinal malrotation presented in the early neonatal period. In 60 patients the classical Ladd’s procedure was performed and was curative. Remaining patients needed resection of the bowel and anastomosis or exteriorization of the bowel. The most common post-operative complication was ileus. Conclusion: A high index of suspicion, a careful history followed by upper GI contrast is essential to diagnose these patients. It is essential to interpret the early symptoms correctly so that the corrective surgery can be performed in time and fatal complications like mid gut volvulus can be prevented.
Authors and Affiliations
Dr Madhukar Maletha, Dr Dhiraj Parihar
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