Abstract
Malrotation occurs when the normal process of intestinal rotation is not complete or is erroneous. The commonest variant being the failure of the final 90° anticlockwise rotation taking the cecum from the right upper quadrant to the right iliac fossa and being fixed in a subhepatic position. The most feared complication of malrotation is volvulus and intestinal infarction though malrotation of itself can present with bile vomiting in the absence of volvulus. The commonest surgical procedure performed is separation and widening of the mesentery at its narrowest point and deliberate positioning of the two ends of the midgut as far from each other as possible with the duodenojejunal flexure on the right side and the cecum and colon on the left—Ladd’s procedure.
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Notes
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William E Ladd (1880–1967)—American surgeon working in Boston, MA, regarded as the father of American pediatric surgery and pioneer in many areas.
Further Reading
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Bartholmot C, Faure J, Grosjean F, et al. Prenatal diagnosis of antenatal midgut volvulus: specific ultrasound features. Prenatal Diagnosis. 2019;39:16–25.
Catania V, Lauriti G, Pierro A, et al. Open versus laparoscopic approach for intestinal malrotation in infants and children: a systematic review and meta-analysis. Pediatr Surg Int. 2016;32:1157–64.
Graziano K, Islam S, Dasgupta R, et al. Asymptomatic malrotation: diagnosis and surgical management. An American Pediatric Surgical Association outcomes and evidence based practice committee systematic review. J Pediatr Surg. 2015;50:1783–90.
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Njere, I., Sinha, C.K., Davenport, M. (2022). Intestinal Malrotation. In: Sinha, C.K., Davenport, M. (eds) Handbook of Pediatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-84467-7_18
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DOI: https://doi.org/10.1007/978-3-030-84467-7_18
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