Abstract:Objective:To investigate the diagnosis and treatment of intestinal malrotation in non-neonatal patients.
Methods:The clinical data of 11 non-neonatal patients with intestinal malrotation were analyzed retrospectively.
Results:Patients presented with vomiting and paroxysmal abdominal pain as the main clinical manifestations. There were no typical symptoms and signs of intestinal malrotation in non-neonatal patients. A diagnosis of intestinal malrotation was made preoperatively in 6 patients by gastrointestinal contrast study, 2 patients by barium meal and ultrasonography and one patient by barium meal and computerized tomography. The preoperative diagnosis rate was 82%. All patients were proven to have intestinal malrotation intraoperatively and underwent a Ladd procedure. Only one patient had postoperative complication of adhesion of intestine, and recovered after conservative treatment. The others recovered well. All the patients received follow-up of 6-60 months and were asymptomatic, except one case of intestinal obstruction that occurred one year later and recovered by non-operative treatment.
Conclusions:The possibility of intestinal malrotation should be suspected in non-neonatal patients with symptoms of recurrent vomiting and abdominal pain. Combining various imaging assays can enhance the diagnosis rate of intestinal malrotation. Ladd procedure is a safe and reliable treatment of intestinal malrotation with low rates of complications.