Management of typical and atypical intestinal malrotation

Background: “Atypical Malrotation” has been increasingly diagnosed at the authors' institution. Methods: The authors reviewed retrospectively 201 consecutive operations for malrotation over 5 years to anatomically classify, and describe results of operation for, atypical malrotation. The ligame...

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Published in:Journal of pediatric surgery 2002-08, Vol.37 (8), p.1169-1172
Main Authors: Mehall, John R., Chandler, John C., Mehall, Rachel L., Jackson, Richard J., Wagner, Charles W., Smith, Samuel D.
Format: Article
Language:English
Subjects:
Adolescent
Adult
atypical malrotation
Biological and medical sciences
Child
Child, Preschool
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Infant
Infant, Newborn
Intestinal malrotation
Intestines - abnormalities
Intestines - surgery
Male
Malformations
Medical sciences
Retrospective Studies
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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cited_by cdi_FETCH-LOGICAL-c439t-247a61684500f52b473df722042f2d67bdad5a4a99c46c1d00edc17d36b0d5ab3
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container_end_page 1172
container_issue 8
container_start_page 1169
container_title Journal of pediatric surgery
container_volume 37
creator Mehall, John R.
Chandler, John C.
Mehall, Rachel L.
Jackson, Richard J.
Wagner, Charles W.
Smith, Samuel D.
description Background: “Atypical Malrotation” has been increasingly diagnosed at the authors' institution. Methods: The authors reviewed retrospectively 201 consecutive operations for malrotation over 5 years to anatomically classify, and describe results of operation for, atypical malrotation. The ligament of Treitz (LOT) was classified as high if left of midline and above the 12th thoracic vertebra, low if left of midline and below the 12th thoracic vertebra, and typical if absent or right of midline. Results: A total of 201 patients underwent operation for malrotation, in 176 there were adequate radiologic studies to allow classification of the LOT. Typical malrotation was present in 75 patients, low LOT in 56, and a high LOT in 45. Volvulus was more common in the Typical group compared with the other 2 groups (12 of 75 v 1 of 56 low; 1 of 45 high; P
doi_str_mv 10.1053/jpsu.2002.34465
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Methods: The authors reviewed retrospectively 201 consecutive operations for malrotation over 5 years to anatomically classify, and describe results of operation for, atypical malrotation. The ligament of Treitz (LOT) was classified as high if left of midline and above the 12th thoracic vertebra, low if left of midline and below the 12th thoracic vertebra, and typical if absent or right of midline. Results: A total of 201 patients underwent operation for malrotation, in 176 there were adequate radiologic studies to allow classification of the LOT. Typical malrotation was present in 75 patients, low LOT in 56, and a high LOT in 45. Volvulus was more common in the Typical group compared with the other 2 groups (12 of 75 v 1 of 56 low; 1 of 45 high; P &lt;.05) as were internal hernias (18 of 75 v 6 of 56 low, 1 of 45 high; P &lt;.05). Complications occurred in 13% of typical versus 22% low and 21% of high patients (P =.10). Low and high LOT patients had 13% and 11% incidence of persistent symptoms postoperatively versus 0% of typical patients. Conclusion: Atypical malrotation patients are at significantly lower risk of volvulus and internal hernia compared with typical malrotation patients, and operation appears to come with increased morbidity. J Pediatr Surg 37:1169-1172. Copyright 2002, Elsevier Science (USA). All rights reserved.</description><identifier>ISSN: 0022-3468</identifier><identifier>EISSN: 1531-5037</identifier><identifier>DOI: 10.1053/jpsu.2002.34465</identifier><identifier>PMID: 12149695</identifier><identifier>CODEN: JPDSA3</identifier><language>eng</language><publisher>Philadelphia, PA: Elsevier Inc</publisher><subject>Adolescent ; Adult ; atypical malrotation ; Biological and medical sciences ; Child ; Child, Preschool ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Infant ; Infant, Newborn ; Intestinal malrotation ; Intestines - abnormalities ; Intestines - surgery ; Male ; Malformations ; Medical sciences ; Retrospective Studies ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><ispartof>Journal of pediatric surgery, 2002-08, Vol.37 (8), p.1169-1172</ispartof><rights>2002</rights><rights>2002 INIST-CNRS</rights><rights>Copyright 2002, Elsevier Science (USA). 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Methods: The authors reviewed retrospectively 201 consecutive operations for malrotation over 5 years to anatomically classify, and describe results of operation for, atypical malrotation. The ligament of Treitz (LOT) was classified as high if left of midline and above the 12th thoracic vertebra, low if left of midline and below the 12th thoracic vertebra, and typical if absent or right of midline. Results: A total of 201 patients underwent operation for malrotation, in 176 there were adequate radiologic studies to allow classification of the LOT. Typical malrotation was present in 75 patients, low LOT in 56, and a high LOT in 45. Volvulus was more common in the Typical group compared with the other 2 groups (12 of 75 v 1 of 56 low; 1 of 45 high; P &lt;.05) as were internal hernias (18 of 75 v 6 of 56 low, 1 of 45 high; P &lt;.05). Complications occurred in 13% of typical versus 22% low and 21% of high patients (P =.10). Low and high LOT patients had 13% and 11% incidence of persistent symptoms postoperatively versus 0% of typical patients. Conclusion: Atypical malrotation patients are at significantly lower risk of volvulus and internal hernia compared with typical malrotation patients, and operation appears to come with increased morbidity. J Pediatr Surg 37:1169-1172. Copyright 2002, Elsevier Science (USA). All rights reserved.</description><subject>Adolescent</subject><subject>Adult</subject><subject>atypical malrotation</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Intestinal malrotation</subject><subject>Intestines - abnormalities</subject><subject>Intestines - surgery</subject><subject>Male</subject><subject>Malformations</subject><subject>Medical sciences</subject><subject>Retrospective Studies</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. 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Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Intestinal malrotation</topic><topic>Intestines - abnormalities</topic><topic>Intestines - surgery</topic><topic>Male</topic><topic>Malformations</topic><topic>Medical sciences</topic><topic>Retrospective Studies</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mehall, John R.</creatorcontrib><creatorcontrib>Chandler, John C.</creatorcontrib><creatorcontrib>Mehall, Rachel L.</creatorcontrib><creatorcontrib>Jackson, Richard J.</creatorcontrib><creatorcontrib>Wagner, Charles W.</creatorcontrib><creatorcontrib>Smith, Samuel D.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mehall, John R.</au><au>Chandler, John C.</au><au>Mehall, Rachel L.</au><au>Jackson, Richard J.</au><au>Wagner, Charles W.</au><au>Smith, Samuel D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of typical and atypical intestinal malrotation</atitle><jtitle>Journal of pediatric surgery</jtitle><addtitle>J Pediatr Surg</addtitle><date>2002-08-01</date><risdate>2002</risdate><volume>37</volume><issue>8</issue><spage>1169</spage><epage>1172</epage><pages>1169-1172</pages><issn>0022-3468</issn><eissn>1531-5037</eissn><coden>JPDSA3</coden><abstract>Background: “Atypical Malrotation” has been increasingly diagnosed at the authors' institution. 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source ScienceDirect Freedom Collection
subjects Adolescent
Adult
atypical malrotation
Biological and medical sciences
Child
Child, Preschool
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Infant
Infant, Newborn
Intestinal malrotation
Intestines - abnormalities
Intestines - surgery
Male
Malformations
Medical sciences
Retrospective Studies
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
title Management of typical and atypical intestinal malrotation
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