The purpose of this case series is to explore the correlation between intestinal malrotation and gastric volvulus.
A retrospective case series with 2 cases is presented. Case 1: The patient is a 5-year-old female with Rett syndrome and multiple comorbidities, and previous Ladd’s procedure for intestinal malrotation. She presented with recurrent episodes of post-feed vomiting and abdominal distension. Her barium swallow revealed an intestinal stricture and gastric volvulus. Six weeks after initial presentation, she underwent strictureplasty, adhesiolysis, gastropexy and Nissen fundoplication. Case 2: The patient is a 9-year-old male, who had a thoracoscopic congenital diaphragmatic hernia repair as a neonate. He presented with severe intermittent upper abdominal pain over 8 months. His upper GI contrast study revealed an abnormal lie of the stomach and intermittent gastric volvulus. He was found to have a very mobile stomach, caecum, right colon and lesser omentum on laparoscopy for which gastropexy and Ladd’s procedure were performed.
Two clear cases of gastric volvulus with a history of either congenital diaphragmatic hernia or intestinal malrotation only are presented. Both patients had resolution of their symptoms.
These two cases illustrate the association between gastric volvulus and intestinal malrotation. The lack of development or incomplete formation of intraperitoneal suspensory ligaments which occurs with the intestinal malrotation is the proposed aetiology.
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Esack, H., Singh, M. Two paediatric cases of chronic gastric volvulus associated with intestinal malrotation. J Ped Endosc Surg 4, 21–23 (2022). https://doi.org/10.1007/s42804-021-00129-2