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Congenital Malrotation of the Colon


Presentation

  • The clinical presentation, surgical management and review of literature are discussed.[ncbi.nlm.nih.gov]
  • If a transesophageal fistula is present to the distal esophagus, gas will be present in the bowel.[quizlet.com]
  • We present a case of a delayed diagnosis of a very common surgical condition, appendicitis. A 92-year-old gentleman presented with a 3 day history of generalized abdominal pain, nausea, vomiting, and weakness.[atlasofscience.org]
  • The frequency of midgut volvulus among infants presenting in the neonatal period ranges from 45% to 80%.[annsaudimed.net]
  • We present a case of a 55-year old man who presented with an acute abdomen with preoperative computed tomography scan and operative findings confirming midgut rotation.[wjes.biomedcentral.com]
Down Syndrome
  • Approximately 8% of infants with Down syndrome have duodenal atresia. [3] Diagnosis [ edit ] The diagnosis of duodenal atresia is usually confirmed by radiography .[en.wikipedia.org]
  • About 20% of patients with Hirschsprung disease have another congenital anomaly, and about 12% have a genetic abnormality ( Down syndrome is the most common).[msdmanuals.com]
  • One of them had associated Down syndrome and another had horseshoe kidney. In all cases, CDW was observed in the second part of the duodenum beyond the ampulla, causing partial duodenal obstruction.[thieme-connect.com]
  • It is associated with a number of other conditions but especially Down's syndrome. See separate Hirschsprung's Disease article.[patient.info]
Arthritis
  • […] onset spinocerebellar ataxia Infantile recurrent chronic multifocal osteomyolitis Infantile sialic acid storage disorder Infantile spasms broad thumbs Infantile spasms Infantile spinal muscular atrophy Infantile striato thalamic degeneration Infectious arthritis[ipfs.io]
  • It is a commonly used anti-arthritis medicine called NSAID (nonsteroidal anti-inflammatory drug).[my.clevelandclinic.org]
Enlarged Uterus
  • In view of the enlarged uterus and the need for retroperitoneal dissection to correct an anatomically anomalous lesion with uncertain vascularity, the surgical opinion was to try nonoperative management first.[degruyter.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]
  • 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]
Colonic Stricture
  • 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

  • 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]
  • 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]
  • Further Reading Symptoms and Diagnosis of Intestinal Malrotation Symptoms and Diagnosis of Intestinal Malrotation Treatment and Prognosis for Intestinal Malrotation[news-medical.net]
  • Kazil understands the important circumstances that drive the treatment with the accuracy and compassion that everyone expects from a consummate general surgeon.[floridasurgicalclinic.com]
  • Persistent symptoms after symptomatic treatment should raise the alarm. Plain abdominal X-ray and US-scans must be used in cases of doubt.[academic.oup.com]

Prognosis

  • Prognosis Survival is primarily dependent on gestation at delivery and the presence of other anomalies.[sonoworld.com]
  • This classification generally guides prognosis and therapy (see the image below). Classification of jejunoileal atresias.[emedicine.medscape.com]
  • Prognosis Survival in MMIHS seems to have improved, thanks to more specialized care, innovations in parenteral nutrition, and introduction of multivisceral transplantation.[orpha.net]
  • These types of anomalies require a multidisciplinary approach in order to establish a prognosis and plan the perinatal management.[redalyc.org]
  • Further Reading Symptoms and Diagnosis of Intestinal Malrotation Symptoms and Diagnosis of Intestinal Malrotation Treatment and Prognosis for Intestinal Malrotation[news-medical.net]

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

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]
  • 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]
  • […] 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]
  • (See "Epidemiology, clinical features, and types of small bowel neoplasms" .)[uptodate.com]
Sex distribution
Age distribution

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]
  • 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]
  • Also vital are maintenance of body temperature, prevention of hypoglycemia with IV 10% dextrose and electrolytes, and prevention or treatment of acidosis and infections so that the infant is in optimal condition for surgery.[merckmanuals.com]
  • The child may also be given intravenous (IV) fluids to help prevent dehydration and antibiotics to prevent infection.[kidshealth.org]

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