Study of the Spectrum of Anomalies of Intestinal Malrotation in Children
Sibghat Ullah, Muhammad Abid Aziz, Sajjad Hussain, Manzoor Hussain, Ashiq Muhammad
1504
ABSTRACTObjective: To assess the spectrum of malrotation in relation to age groups in terms of symptoms as well as the anatomical types of malrotation.Study Design: Prospective studyPlace and Duration of Study: Children’s Hospital, PIMS, Islamabad from 1st June 2019 to 31st January 2020.Methodology: All patients presenting to the outpatients’ department or the emergency room were included in the study. Patients who were unstable or had inconclusive evidence for malrotation were excluded. All participants underwent barium studies and Doppler ultrasonography which confirmed the diagnosis. The data was collected through a proforma incorporating clinical presentation, physical examination, investigations, and operative findings.Results: The mean age of the patients was 8.6±20.3 months. Majority was male. In the neonatal age group, 10 (31.3%) patients had pain, 32 (100%) had vomiting and 28 (87.5%) had abdominal distension. In the patients under 1 year of age, 7 (70%) had pain, 9 (90%) had vomiting and 7 (70%) had abdominal distention. Of the patients between 12 to 59 months, 6 (100%) had pain 1 (16.7%) had vomiting and 4 (66.7%) had abdominal distention. 31 (62.0%) of patients each had dilated gut loop and air fluid level on x-ray. The Doppler ultrasound found out reverse pattern of superior mesenteric artery and vein in 27 (54.0%) cases.Conclusion: The intestinal malrotation presents in early life within one month of life in two third of cases, however, a substantial number of cases can present in infancy and few even present later in life.Keywords: Anomaly, Duodeno-jejunal loop, Intestinal malrotation, Pediatric
Objective: To assess the spectrum of malrotation in relation to age groups in terms of symptoms as well as the anatomical types of malrotation.
Study Design: Prospective study
Place and Duration of Study: Children’s Hospital, PIMS, Islamabad from 1st June 2019 to 31st January 2020.
Methodology: All patients presenting to the outpatients’ department or the emergency room were included in the study. Patients who were unstable or had inconclusive evidence for malrotation were excluded. All participants underwent barium studies and Doppler ultrasonography which confirmed the diagnosis. The data was collected through a proforma incorporating clinical presentation, physical examination, investigations, and operative findings.
Results: The mean age of the patients was 8.6±20.3 months. Majority was male. In the neonatal age group, 10 (31.3%) patients had pain, 32 (100%) had vomiting and 28 (87.5%) had abdominal distension. In the patients under 1 year of age, 7 (70%) had pain, 9 (90%) had vomiting and 7 (70%) had abdominal distention. Of the patients between 12 to 59 months, 6 (100%) had pain 1 (16.7%) had vomiting and 4 (66.7%) had abdominal distention. 31 (62.0%) of patients each had dilated gut loop and air fluid level on x-ray. The Doppler ultrasound found out reverse pattern of superior mesenteric artery and vein in 27 (54.0%) cases.
Conclusion: The intestinal malrotation presents in early life within one month of life in two third of cases, however, a substantial number of cases can present in infancy and few even present later in life.
Keywords: Anomaly, Duodeno-jejunal loop, Intestinal malrotation, Pediatric