Malrotation and volvulus in children

Question 1

What is malrotation of the intestine in children (RF. SX)

Answer 1

a spectrum of disorders caused by disturbanced during development -variants
abnormal rotation in embryo can lead to blockage /volvus later

RF -nil

Present as obstruction in children < 1 yhear (50-75% in first month)
Bilious vomit (green) 
Abdo pain
normal abdo exam/Abdo distended/abdo tender

ischeamic–
Heamodynamically unstable
peritoneal signs
Malena in nappy

partial volvulus can present more with weigth loss

Question 2

Ix and Mx of Malrotation and volvulus

Answer 2

Upper GI contrast series -diagnostic standard test - can see the projection, what form of malrotation is present and volvulus

CT with contrast -if concern is low
AXR -urgent care but not great
FBC -if heamo unstable

Mx -surgery
Open laporotomy and LADDs procedure (where just turn the twisted bowel anti-clockwwise)