intestinal malrotation

Question 1

embryology

Answer 1

during normal development he foregut, midgut and hangout herniate out from the abdominal cavity where they undergo a 270 degrees counter-clockwise rotation around the superior mesenteric vessels, they then return to the abdominal cavity resulting in fixation of the duodenojejunal loop to left of the midline fixated by the ligament of treitz and the caecum is fixated in the right lower quadrant

Question 2

intestinal malortation

Answer 2

is any variation in this rotation and fixation of the GI tract during development and predisposes to volvulus because of a narrower mesentery and the formation of lands bands

Question 3

if the rotation is incomplete

Answer 3

the proximal and distal midgut mesentery fuse around the SMA and the caecum and duodenum are closely adherent resulting in obstruction and the formation of lands bands which can causes volvulus

Question 4

symtoms

Answer 4

• billous vomiting is volvulus caused by malrotation intel proves otherwise
• abdominal pain and distention
• eventually the bowel infarcts and can result in blood stool

Question 5

investigations

Answer 5

GI study (barium swallow) shows a classical corkscrew appearance

Question 6

management

Answer 6

ladds procedure