Topics Discussed: acute abdomen; acute illness; incarcerated hernia; intestinal obstruction; intussusception; malrotation, congenital; pyloric stenosis; volvulus, intestinal.
Sections: Intra-Abdominal Sepsis, Gastrointestinal Foreign Bodies, Megacolon, References.
Excerpt:"An arrest of the normal embryonic rotation of the alimentary tract may result in suspension of sections of bowel, including the vascular supply, by a narrow pedicle. Three outcomes are possible. Least likely (<10% of all patients with malrotation) is the lifelong absence of symptoms. More likely, a rotational anomaly will create a vague gastrointestinal symptom such as failure to thrive, chronic recurrent abdominal distension, pain-free episodic vomiting, or persistent unexplained diarrhea. Most likely, especially with malrotations about the duodenum, small bowel, and colon up to the midtransverse portion (the midgut), a strangulating twist affects dramatic symptomatology.3 Males are affected twice as often as females. Nearly half of all patients present within the first week of life, two-thirds present within the first month, and more than 90% present within the first year of life.4..."
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