Abstract
137 cases of malrotation and midgut volvulus seen over a 28-year period are reviewed to emphasize the patterns of clinical presentation. Although 62% presented as neonates, 20% were over 1 year of age. Vomiting was the sympton of paramount importance in 97% but was not initially bile-stained in 20%. Sixteen percent had diarrhea as a major symptom. Abdominal pain occurred in 96% of patients over 1 year of age. Clinical signs were not apparent in most cases until gut infarction had occurred. Radiographic examination of the abdomen was considered normal in more than 20%. Barium meal was the contrast examination with most accuracy and should be diagnostic if correctly interpreted. The significant mortality (19%) in all age groups was invariably related to delay in presentation or diagnosis.
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Millar, A.J.W., Rode, H., Brown, R.A. et al. The deadly vomit: malrotation and midgut volvulus. Pediatr Surg Int 2, 172–176 (1987). https://doi.org/10.1007/BF00185145
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DOI: https://doi.org/10.1007/BF00185145