Ch. 330.3 - Malrotation

Question 1

Malrotation is INCOMPLETE rotation of the intestine during fetal development and involves intestinal non rotation or incomplete rotation around the ___

Answer 1

SMA

Question 2

Intestinal rotation and attachment begins when

Answer 2

5th week of gestation

Question 3

Abdominal rotation and attachment are completed by ___

Answer 3

12th week of gestation

Question 4

Normal configuration of organs after rotation

Answer 4

Duodenum at the region of the LOT, colon at the LUQ, cecum at the RLQ

Question 5

Configuration of organs in the abdominal cavity in nonrotation

Answer 5

1st and 2nd portions of duodenum in the normal position, remainder of duodenum, jejunum, and ileum on the right, colon on the left

Question 6

MC type of malrotation

Answer 6

Failure of cecum to move to the RLQ in the sub hepatic area

Question 7

Bands of tissue that can extend from the cecum to the RUQ, crossing and possibly obstructing the duodenum seen in malrotation

Answer 7

Ladd bands

Question 8

T/F Malrotation and non rotation are often associated with other abnormalities of the abdominal wall

Answer 8

T

Question 9

GI anomaly associated with asplenia

Answer 9

Malrotation

Question 10

Majority of malrotations present within

Answer 10

1st year of life

Question 11

> 50% of malrotation presenting in the 1st year of life present during

Answer 11

1st month of life

Question 12

MC symptom of malrotation during infancy

Answer 12

Vomiting

Question 13

Approximately 25-50% of patients with malrotation in this age group are asymptomatic

Answer 13

Adolescents

Question 14

A life-threatening complication of malrotation, which resembles an acute abdomen or sepsis and is the main reason that symptoms suggesting malrotation should always be investigated

Answer 14

Volvulus

Question 15

Radiograph may demonstrate a gasless abdomen or evidence of duodenal obstruction with a double-bubble sign

Answer 15

Volvulus

Question 16

Gold standard in the evaluation and diagnosis of malrotation and volvulus

Answer 16

UGIS

Question 17

Normal intestinal rotation is seen on UGIS as

Answer 17

1) Duodenal C-loop crossing the midline 2) Duodenojejunal junction located to the left of the spine

Question 18

Best exam to visualize malposition of the LOT

Answer 18

UGIS

Question 19

Positioning of superior mesenteric vessels seen on UTZ that can suggest malrotation

Answer 19

SMV located to the left of the SMA

Question 20

Recommended management for any patient with a significant rotational abnormality REGARDLESS OF AGE

Answer 20

Surgical intervention: Ladd procedure

Question 21

T/F Purpose of surgical intervention in malrotation is to return organs to normal configuration

Answer 21

F, To minimize the risk of subsequent volvulus

Question 22

UGIS picture of malrotation

Answer 22

Corkscrew appearance of small bowel OR duodenal obstruction with a bird’s beak appearance of duodenum