Vólvulo de intestino medio: a propósito de dos casos.

Lucia Z Diaz ,Martín Ormaechea ,Carlos Juambeltz

doi:10.25184/anfamed2021v8n1a8

Lucia Z Diaz , Martín Ormaechea + Show 1 more

Open Access

https://doi.org/10.25184/anfamed2021v8n1a8

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Abstract

Intestinal malrotation is defined as an alteration in the rotation and fixation of the intestine during the fetal stage. It can present with a wide clinical spectrum ranging from acute volvulus to chronic duodenal obstruction. Its clinical presentation is therefore also very varied, from asymptomatic patients in whom the diagnosis can be made as a finding, to extremely serious symptoms such as a midgut volvulus. Midgut volvulus is the most severe manifestation of this malformation spectrum, and its presentation without ischemia in asymptomatic patients is a rare formof presentation. The objective of this work is to present the clinical history of two patients with intestinal malrotation who presented a midgut volvulus in the neonatal period. In both cases, a Ladd procedure was performed, requiring in the first patient a extensive intestinal resection due to intestinal necrosis. Both had a good progress in the postoperative period.

Highlights

Intestinal malrotation is a spectrum of malformations that includes a great variety of alterations in the rotation and fixation process of the intestines
The two cases are analyzed under a relevant bibliographic revision, knowledge is derived from the carried-out management and evolution, and elements for the future optimization of management are underlined
El mismo consta de los siguientes pasos: evisceración completa del intestino, devolvulación (dado que habitualmente el intestino rota en sentido horario, esta debe realizarse en sentido antihorario -viendo al paciente desde los pies-), sección de las bridas de Ladd si existen y rectificación del duodeno, apertura amplia de la raíz del mesenterio común ensanchando su base, apendicectomía (controversial en el momento actual, pero descripta en la técnica original) y por último reintroducción del intestino al abdomen dejando el delgado a la derecha de la columna y el colon a la izquierda, con el ciego a nivel del flanco izquierdo

Summary

Introduction

Intestinal malrotation is a spectrum of malformations that includes a great variety of alterations in the rotation and fixation process of the intestines.

Results

Conclusion