Pediatric Surgery

Question 1

What does this picture depict?

Answer 1

Intestinal malrotation - abnormally located duodenojejunal junction due to Ladd’s bands - abnormal right retroperitoneal attachments

Question 2

Treatment for intestinal malrotation?

Answer 2

Ladd’s procedure

Question 3

Ladd’s procedure 5 steps

Answer 3

1. Counterclockwise detorsion of the small bowel mesentery
2. Divide the abnormal retroperitoneal attachments to the duodenum (Ladd’s bands)
3. Widen the narrowed root of the small bowel mesentery by dividing adhesions between the duodenum and cecum
4. Perform an appendectomy
5. Place the small bowel to the right of the abdomen and the cecum to the left of the abdomen

Question 4

Target sign is classic for?

Answer 4

Intussuception