Presence Of Malrotation Research Articles

Midgut malrotation presenting in adult life.

Midgut malrotation presenting in adult life.

Adult bochdalek hernia

Acquired diaphragmatic hernias are most commonly associated with traumatic thoracic injury and rarely heal spontaneously. Conditions that promote peritoneal seeding, such as endometriosis, are associated with spontaneous acquired diaphragmatic hernia formation. Non-traumatic acquired diaphragmatic herniation has previously been described in the context of catamenial pneumothorax, however post-menopausal endometriotic diaphragmatic herniation has not been previously reported.A 57 year old post-menopausal female presented with a strangulated ischaemic loop of small bowel herniating through an acquired right sided endometriotic diaphragmatic hernia not previously visualised on imaging. Clamshell thoracolaparotomy was conducted and the necrotic section of small bowel was resected. The diaphragm was repaired and the patient recovered post-operatively without complications.This patient had a complete intestinal malrotation presenting acutely with a small bowel obstruction and herniation through an acquired diaphragmatic rupture. This was possibly related to a diaphragmatic defect caused by endometriosis.We presented a case of a post-menopausal acquired diaphragmatic herniation secondary to endometriosis; resulting in acute intestinal obstruction and bowel infarction. To our knowledge, such a case has not been previously reported in existing literature.

Late presentation of malrotation: An argument for elective repair

Introduction. Midgut malrotation is not commonly diagnosed in adults. We reviewed our experience and present one of the largest reported series of operative repair of malrotation in adolescents and adults. Methods. Retrospective review of medical records that carried the diagnosis of anomaly of intestinal fixation or malrotation was performed in our health system between September 1993 and February 2004. Results. Since 1993, we treated 32 patients with varying degrees of malrotation whether the presentation be acute, chronic, or incidental with a Ladd Procedure. Ages ranged from 11 to 83 years old (mean 33), with a slight male preponderance (56% male). Symptoms were present from less than one day to most of a lifetime. Patients presented with acute abdominal pain (50%), nausea and vomiting (59%), constipation (50%), abdominal distention (41%) and chronic abdominal pain (25%). Initial work-up included CAT scan (28%), UGI study (38%), and plain films (47%) prior to surgery. Twenty-eight percent of patients were found to have midgut malrotation incidentally during an operation for another reason. All patients underwent Ladd’s procedure. Complications occurred in 22% of the incidental group, 25% in the elective group, and 60% of the nonelective/nonincidental group. Prolonged postoperative ileus (4 days) occurred in 28% of patients; however, patients that had their malrotation repaired electively had a lower rate of prolonged ileus: 11% in the incidental group, 25% in the elective group, and 40% in the nonelective/nonincidental group. Average length of stay was 7.6 days. Symptoms attributed to malrotation resolved in all cases. There were no second-look operations and no mortalities. Conclusion. Intestinal malrotation is an important entity to consider in nonpediatric patients with vague abdominal complaints. When symptoms progress to acute abdominal pain, postoperative complications are greater. Based on our experience with late presentation of intestinal malrotation, we recommend elective Ladd’s procedure, which can be performed safely.

Disorders of intestinal rotation and fixation ("malrotation").

Malrotation with volvulus is one of the true surgical emergencies of childhood. Prompt radiological diagnosis is often paramount to achieving a good outcome. An understanding of the normal and anomalous development of the midgut provides a basis for understanding the pathophysiology and the clinical presentation of malrotation and malrotation complicated by volvulus. In this essay, the radiologic findings of malrotation and volvulus are reviewed and illustrated with particular attention to the child with equivocal imaging findings.

Pit-fall of Diagnosis and Treatment on the Malrotation Presenting Beyound the Neonatal Period

Pit-fall of Diagnosis and Treatment on the Malrotation Presenting Beyound the Neonatal Period

Malrotation of Gut with Internal Mesocolic Hernia Mimicking Mesenteric Cyst

Various clinical presentations from chronic abdominal pain to acute midgut volvulus with ischaemic bowel injury may result from failure of normal intestinal rotation and fixation. A patient having malrotation and internal herniation of gut clinically presented to us with intermittent abdominal pain, bilious vomiting and abdominal mass mimicking mesenteric cyst. This is a very rare and exceptional form of presentation of malrotation of gut. Rarity of the clinical presentation leads us to report this case. DOI: http://dx.doi.org/10.3329/taj.v14i2.8395 TAJ 2001; 14(2): 90-91

Presentation of midgut malrotation in adults.

Presentation of midgut malrotation in adults.