Intestinal Malrotation in Older Children : A Case Report
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Abstract
Background: Intestinal malrotation is an anatomic abnormality that allows the midgut to twist in a clockwise direction around the superior mesenteric vessels or depress the duodenum to obstruct. Most patients with intestinal malrotation and gut obstruction present in the first year of life but presentation can occur at any age. In older children, the diagnosis is more difficult because of chronic and vague complaints. The author presented two cases of intestinal malrotation in older childrens who presented with midgut volvulus and chronic duodenal obstruction.
Objective: To report a case of intestinal malrotation with gut obstruction in older childrens in Buriram Hospital.
Methods: Case report
Case report: Two boy patients presented with repeated bilious vomiting. Film abdomen showed dilated stomach and duodenum in one child and upper GI contrast study showed duodenal obstruction. Exploratory laparotomy revealed intestinal malrotation, the first patients had midgut volvulus and the another had chronic duodenal obstruction. Ladd's procedure and appendectomy were performed. There were no complication after surgery.
Conclusion: Intestinal malrotation should be considered as a differential possibility in the diagnosis of abdominal disorders in older children. The investigation were upper GI contrast study and abdominal ultrasound. The prompt investigation and treatment could prevent short bowel syndrome that cause high mortality rate.
Key words: intestinal malrotation, midgut volvulus, duodenal obstruction
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References
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