Malrotation and volvulus Flashcards
1
Q
A bit of embryology
A
At week four, GI system is a straight tube centrally located in the abdomen
During next eight weeks, midgut rotates and attaches to posterior wall
Arrest of development narrows the mesenteric base and impairs fixation => higher risk of volvulus
2
Q
Volvulus
A
Twisting of a loop of bowel around its mesenteric attachment site
Can occur at various points of the GI tract
3
Q
Malrotation
A
Twisting of the entire midgut around the axis of the superior mesenteric artery
4
Q
Clinical features
A
Malrotation - intermittent obstruction Volvulus - complete obstruction Bilious vomiting (>2y also non-bilious) Feeding intolerance Failure to thrive Anorexia Constipation Bloody stools Intermittent apnoea Older children: cyclical vomiting, recurrent abdo pain, immunodeficiency, malnutrition If ischeamic - PAIN!!
5
Q
Management
A
Surgical - Ladd’s procedure
