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2.1
Congenital Malrotation of the Colon
Malrotation Colon

Presentation

We present the case of a newborn who, hours after childbirth, presents data on sepsis and clinical signs of complete intestinal obstruction: biliary drainage through the orogastric tube, peristalsis present and decreased fecal output, it should be mentioned [go.gale.com]

At present, there is no consensus on the treatment of abdominal cocoon disease. [bmcsurg.biomedcentral.com]

In some individuals, the presentation is very non-specific, with episodes of abdominal pain, weight loss, melena, or even chronic pancreatitis 5. [radiopaedia.org]

It is responsible for 1–1.5% of all adult intestinal obstructions and 25–40% of all volvulus involving the colon [1] and is one of the modes of presentation of intestinal malrotation and abnormal fixation that commonly presents in early childhood. [karger.com]

Entire Body System

  • Trisomy 21

    Risk Factors: Associated Syndromes Familial Intestinal Malrotation Marfan Syndrome Prune Belly Syndrome Chromosomal abnormalities Trisomy 13 Trisomy 18 Trisomy 21 Other conditions (e.g. [fpnotebook.com]

    We report a case of prolonged nonchylous ascites associated with intestinal malrotation in an infant with trisomy 21 who was eventually treated successfully with surgical intervention. [journals.lww.com]

    Related conditions include cystic fibrosis, Trisomy 21 (Down syndrome), congenital heart disease, bowel rotational abnormality, annular pancreas, esophageal atresia, anorectal atresia and genitourinary conditions. [chop.edu]

    Chromosomal abnormalities (mainly trisomy 18 or 21) are found in about 20% of fetuses. Other major defects, mainly cardiac, are found in about 50% of the cases. [sonoworld.com]

    She had trisomy 21. She had been operated on for malrotation at 8 months (Valdoni’s procedure) and for duodenal stenosis at 9 months (duodenotomy and resection of a congenital web). [e-ce.org]

Respiratoric

  • Rhinitis

    An 18-year-old girl with a history of migraine headaches, allergic rhinitis, ovarian cysts, and multiple food allergies was referred to the ED with complaints of poorly localized abdominal pain and nausea without vomiting. [westjem.com]

Gastrointestinal

  • Decreased Bowel Sounds

    She had presented to her primary care physician (PCP) earlier in the day with similar complaints and was noted to have decreased bowel sounds and diffuse abdominal tenderness to palpation. [westjem.com]

Workup

The diagnostic preoperative workup should include a plain abdominal radiograph, upper and/or lower gastrointestinal contrast studies, and ultrasonography (1). [journals.lww.com]

A thorough workup was notable for congenital bowel malrotation; symptoms were relieved following surgical treatment. [westjem.com]

When he lost his medical insurance, he was discharged and advised to have further workup performed elsewhere. [hindawi.com]

Ghassemian AJ, MacDonald KG, Cunningham PG, Swanson M, Brown BM, et al. (1997) The workup for bariatric surgery does not require a routine upper gastrointestinal series. Obes Surg 7: 16-18. [omicsonline.org]

They may also be encountered incidentally at the time of workup for other diseases. [liebertpub.com]

X-Ray

  • Colonic Stricture

    CMV infection should always be excluded in full-term infants presenting with colonic stricture or malrotation. [ijponline.biomedcentral.com]

    Tuberculosis-associated left colon stricture has also been reported. [13] Patients who undergo bowel resection for any reason and have a segment of intestine removed and joined by anastomosis may develop stricture at the anastomotic site as a consequence [emedicine.medscape.com]

Treatment

At present, there is no consensus on the treatment of abdominal cocoon disease. [bmcsurg.biomedcentral.com]

Surgical management is the definitive treatment and leads to resolution of abdominal symptoms. [westjem.com]

Volvulus is therefore an emergency that requires immediate surgical treatment. Malrotation of the bowel during fetal development may predispose infants to volvulus, although volvulus can occur in the absence of malrotation. [hopkinsmedicine.org]

Treatment and prognosis depends largely upon the viability of the dilated cecum. Surgery is the only definite treatment of the cecal volvulus. Case Report A 23-year-old male with known anorectal malformation underwent PCNL for left pelvic calculus. [karger.com]

Treatment [ edit ] Early treatment includes removing fluids from the stomach via a nasogastric tube, and providing fluids intravenously. [1] The definitive treatment for duodenal atresia is surgery (duodenoduodenostomy), which may be performed openly [en.wikipedia.org]

Prognosis

Abstract With advances in surgery and the use of the antibiotics, the prognosis of congenital obstruction of the duodenum has become much more favorable. [pubs.rsna.org]

Prognosis Survival is primarily dependent on gestation at delivery and the presence of other anomalies. [sonoworld.com]

It is key to improve the prognosis and reduce complications. Keywords: acute abdomen, intestinal malrotation, volvulus. Get Full Access Gale offers a variety of resources for education, lifelong learning, and academic research. [go.gale.com]

This classification generally guides prognosis and therapy (see the image below). Classification of jejunoileal atresias. [emedicine.medscape.com]

These types of anomalies require a multidisciplinary approach in order to establish a prognosis and plan the perinatal management. [redalyc.org]

Etiology

Risk factors — Factors that increase the risk for the most common etiologies of small bowel obstruction are given in the table ( table 1 ). (See 'Specific etiologies' below.) [uptodate.com]

Etiology Multiple theories regarding the etiology of jejunoileal atresia have been studied in many animal models (eg, puppies, ewes, rabbits, and chick embryos). [22, 23, 24, 25, 26] Murine studies suggest that some forms of atresia may be hereditary [emedicine.medscape.com]

Etiology Duodenal atresia is a sporadic abnormality, although, in some cases, there is an autosomal recessive pattern of inheritance. [sonoworld.com]

Keywords: Adult, Case Report, Duodenum, abnormalities,Female, Human, Intestinal Obstruction, etiology,Pregnancy, Pregnancy Complications, etiology, How to cite this article: Hardikar J V. Malrotation of the gut manifested during pregnancy. [jpgmonline.com]

DISCUSSION Malrotation remains the most common etiology of volvulus in neonates, though a rare cause in adults. It is due to an error in embryologic gut development. [academic.oup.com]

Epidemiology

Epidemiology References: [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Epidemiology In the United States, for example, asymptomatic GI malrotation occurs with an incidence somewhere between 1 in 200 to 1 in 500. [news-medical.net]

[…] intravenously. [1] The definitive treatment for duodenal atresia is surgery (duodenoduodenostomy), which may be performed openly or laparoscopically. [6] The surgery is not urgent. [1] The initial repair has a 5 percent morbidity and mortality rate. [2] Epidemiology [en.wikipedia.org]

Summary Epidemiology MMIHS prevalence is unknown but the disease has been reported in 230 patients, of which 71% are females. Clinical description Enlarged and nonobstructed bladder is the first manifestation of MMIHS and can be detected prenatally. [orpha.net]

(See "Epidemiology, clinical features, and types of small bowel neoplasms" .) [uptodate.com]

Pathophysiology

Lower Digestive Tract, 2nd Edition, part 2 in the 3-book Digestive System volume, covers the small bowel and colon, and provides a concise and highly visual approach from normal anatomy and physiology through pathophysiology, diagnostics and treatment [books.google.com]

Pathophysiology In the scenario of little or no rotation, the duodenum does not completely rotate and cross posterior to the SMA to allow creation of a normal ligament of Treitz on the left side of the abdomen. [online.epocrates.com]

Risk factors for the development of a volvulus References: [2] [3] [4] [5] [12] [13] [14] [15] [16] Pathophysiology Sigmoid volvulus Initial resuscitation : IV fluids ; acid-base and electrolyte imbalance correction ; n il per oral ; placement of a nasogastric [amboss.com]

Pathophysiology GI malrotation, has been recently suggested to result from genetic mutations. The gene implicated is the fork head transcription factor (FOXF1) gene. [news-medical.net]

Pathophysiology Malrotation refers to impaired rotational process of the midgut as it returns from outside of the abdominal cavity (extracoelomic phase of development) to the abdominal cavity. [pedclerk.bsd.uchicago.edu]

Prevention

[…] dehydration and antibiotics to prevent infection. [luriechildrens.org]

The fluids keep them from becoming dehydrated, and the antibiotics prevent infections. A nasogastric tube is placed from the nose into the stomach to prevent gas buildup in the stomach. [chp.edu]

Prevention There are no current guidelines to prevent volvulus. [azkrmc.com]

Children may be started on IV (intravenous) fluids to prevent dehydration and antibiotics to prevent infection. [stanfordchildrens.org]

The child may also be given intravenous (IV) fluids to help prevent dehydration and antibiotics to prevent infection. [kidshealth.org]

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