[25] Malrotation and Volvulus Flashcards
What is malrotation?
An abnormality of the bowel that occurs during development where the bowel does not sit properly in the abdomen
When does malrotation most commonly become evident?
When midgut volvulus occurs
What is a volvulus?
A complication of malrotation where the bowel twists on itself, cutting off its own blood supply
When does malrotation occur?
Due to improper development beginning at around the 10th week
How is the bowel supposed to develop at around 10 weeks?
The bowel temporarily moves into the umbilical cord to develop and is supposed to move back into the abdomen at 10 weeks
What goes wrong during development to cause malrotation?
Inappropriate coiling as the bowel moves back into the abdomen
What type of volvulus typically occurs as a result of malrotation?
Midgut (small intestine) volvulus
Who do small gut volvuluses most commonly occur in?
Children
What type of volvulus is more common in adults?
Sigmoid volvulus
What is the radiological sign for a sigmoid volvulus?
Coffee bean sign
How may malrotation present?
- Acute process
- Chornic process
What is the acute process seen in malrotation?
Acute midgut volvulus
When does an acute midgut volvulus usually present?
In the first year of life
How does an acute midgut volvulus usually present?
- Sudden onset bilious emesis
- Diffuse abdominal pain
- Abdominal distension
- Melena/haematemesis
What causes melena/haematemesis to occur?
Intraluminal bleeding due to vascular compromise
