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Comparative study of intestinal malrotation in infant, children, and adult in a tertiary care center in India

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Abstract

Background

Intestinal malrotation (IM) is an uncommon condition and has varied presentation in different age groups. The study was aimed to evaluate differences in the clinical presentation, diagnosis, treatment, and outcome of IM in infants, children, and adults.

Methods

Data were collected from records of 79 patients with IM. Based on the age of presentation, these patients were categorized into three age groups: infants (up to 1 year), children (1–18 years), and adults (> 18 years). Follow up data were analyzed during 8 to 16 year after corrective surgery.

Results

The overall age of presentation ranged from 8 days to 60 years. Twenty-eight, 29, and 22 patients belonged to the infant, children, and adult groups, respectively. The classical presentation of IM (bilious vomiting) was significantly higher in the infant compared to the children and adult groups (100% vs. 62% vs. 9.8%; p < 0.001). All infants presented with acute symptoms. However, children and adults had subacute or chronic presentations, respectively. The incidence of volvulus was significantly higher in the infant group than other two groups, (100% vs. 41% vs. 10%; p < 0.001). Doppler ultrasound was highly accurate in infants (100%), whereas contrast-enhanced computed tomography (CECT) abdomen was found to be most useful in adults. Postoperative complications were more common in adults.

Conclusion

Intestinal malrotation can present in patients of any age group. An increased awareness about the atypical presentations of this condition among adults may reduce the time to accurate diagnosis of this disease.

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Acknowledgments

The authors acknowledge the contribution of Dr. Alok Ranjan, Assistant Professor, Department of Community and Family Medicine, AIIMS, Patna for statistical analysis.

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Authors and Affiliations

  1. Department of Surgical Gastroenterology, All India Institute of Medical Sciences, AIIMS Road, No. 1, Phulwari Sharif, Patna, 801 507, India

    Utpal Anand

  2. Department of Gastroenterology, All India Institute of Medical Sciences, AIIMS Road, No. 1, Phulwari Sharif, Patna, 801 507, India

    Ramesh Kumar

  3. Department of Radiodiagnosis, All India Institute of Medical Sciences, AIIMS Road, No. 1, Phulwari Sharif, Patna, 801 507, India

    Rajeev N. Priyadarshi

  4. Department of Pediatric Surgery, All India Institute of Medical Sciences, AIIMS Road, No. 1, Phulwari Sharif, Patna, 801 507, India

    Bindey Kumar

  5. Department of Surgical Gastroenterology, Indira Gandhi Institute of Medical Sciences, Bailey Road, Raja Bazar, Sheikhpura, Patna, 800 014, India

    Sanjay Kumar

  6. Department of Gastroenterology, Patna Medical College and Hospital, Ashok Rajpath Road, Patna University Campus, Patna, 800 001, India

    Vijay Prakash Singh

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  1. Utpal Anand
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  2. Ramesh Kumar
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  3. Rajeev N. Priyadarshi
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  4. Bindey Kumar
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  5. Sanjay Kumar
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Corresponding author

Correspondence to Utpal Anand.

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Conflict of interest

UA, RK, RNP, BK, SK, and VPS declare that they have no conflict of interest.

Ethical clearance

The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Informed consent

Written informed consent was obtained from all the patients for participation in this study.

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Anand, U., Kumar, R., Priyadarshi, R.N. et al. Comparative study of intestinal malrotation in infant, children, and adult in a tertiary care center in India. Indian J Gastroenterol 37, 545–549 (2018). https://doi.org/10.1007/s12664-018-0914-1

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  • DOI: https://doi.org/10.1007/s12664-018-0914-1

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