Malrotation is a developmental lack of fixation of the intestine that can lead to twisting of the intestines or bowel. This lack of fixation occurs in utero but the twisting usually occurs later. Eighty percent of the patients who have a twist (mid gut volvulus) have this in the first year of life. If the twisting occurs it can lead to severe infection and loss of up to 95% of the intestines. The long-term consequences of this “short gut syndrome” are severe.
May be associated with:
Problems that occur from malrotation:
Symptoms:
Treatment:
Surgery:
Ladd’s procedure: The intestine is straightened out, the bands are divided, the mesentery which holds the bowel in place is widened to provide a more stable base for the bowel. The small intestine is placed on the right side of the abdomen and the colon on the left. Usually, the appendix is removed, as well.
In cases where the intestine has lost its blood supply due to twisting, a portion of the intestine is removed. Results are directly related to how much intestine has died and require removal. In these cases the patients may be severely sick with sepsis. This will occasionally require an ileostomy or colostomy. This is usually temporary and can be reversed several months later with another operation.
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