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Malrotation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Simon Blackburn, Joseph I. Curry, Bhanumathi Lakshminarayanan
Acute, life-threatening, strangulating intestinal obstruction occurs as a result of midgut volvulus. The infant presents in a shocked and collapsed state with bilious vomiting (which often contains altered blood), abdominal tenderness with or (more commonly) without distension, and the passage of dark blood rectally. Edema and erythema of the abdominal wall develop as the volvulus becomes complicated by intestinal gangrene, perforation, and peritonitis.
Paper 3
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Ultrasound and fluoroscopy can be helpful in assessing for midgut volvulus. Ultrasound findings include the ‘whirlpool’ sign caused by a twisting of the mesenteric vessels. The superior mesenteric vein usually lies to the right of the superior mesenteric artery; in malrotation it lies to the left. The retro-mesenteric D3 part of the duodenum may not be visible between the aorta and superior mesenteric vessels.
The abdomen
Published in Spencer W. Beasley, John Hutson, Mark Stringer, Sebastian K. King, Warwick J. Teague, Paediatric Surgical Diagnosis, 2018
Spencer W. Beasley, John Hutson, Mark Stringer, Sebastian K. King, Warwick J. Teague
An uncommon but extremely important cause of small- volume rectal bleeding is ischaemia of the bowel with impending gangrene, as is seen in volvulus secondary to intestinal malrotation and in advanced ileocolic intussusception. The child is in pain and may have bile-stained vomiting. With midgut volvulus there is rapid progression of symptoms and signs. Eventually the abdomen becomes distended, with widespread abdominal tenderness and guarding. By the time signs of peritonitis occur, there is almost certainly dead bowel already.
Massive ascites and severe pulmonary hypoplasia in a premature infant with meconium peritonitis and congenital cytomegalovirus infection
Published in Fetal and Pediatric Pathology, 2020
During normal fetal development, the gastrointestinal tract herniates out of the abdominal cavity, undergoes a 270° counterclockwise rotation around the superior mesenteric artery, and returns to the abdominal cavity. The duodenojejunal loop is then fixed to the left of the midline and the cecum to the right lower quadrant. If this process is interrupted at any point during fetal development, the result is known as intestinal malrotation, which can lead to a range of gastrointestinal abnormalities, the most common of which being midgut volvulus.
Protective Effects of Hydrogen-Rich Saline on Experimental Intestinal Volvulus in Rats
Published in Journal of Investigative Surgery, 2022
Hayrunnisa Oral, Zafer Türkyılmaz, Ramazan Karabulut, Cem Kaya, Duygu Dayanır, Cengiz Karakaya, Kaan Sonmez
Midgut volvulus is frequently seen due to malrotation, with approximately 50% of the cases occurring in the first week of life and more than 60% in the first month of the neonatal period. The intestinal volvulus is formed by the rotation of the small intestines around their mesenteric pedicle and superior mesenteric vessels [21, 22]. The obstruction by the volvulus first affects lymphatic drainage, followed by disruption of the venous drainage and arterial blood flow due to the increased pressure [23]. Subsequently, an ischemic state ensues.
Primary midgut volvulus without intestinal malrotation in a young adult: a case report
Published in Acta Chirurgica Belgica, 2020
Nicolas De Hous, Charles de Gheldere, Rodrigo Salgado, Filip Gryspeerdt
Midgut volvulus is a well-known complication of intestinal malrotation usually occurring in infants and young children [2]. In contrast, primary midgut volvulus occurs in the setting of normal intestinal rotation and mesenteric fixation. This condition is extremely rare, with only a handful of cases described in the literature. In this report, we present the rare case of a young adult with a midgut volvulus in whom no underlying cause could be identified.