Malrotation of the midgut in infants and children: a 25-year review
R. J. Andrassy and G. H. Mahour
Seventy-four patients were operated on at Childrens Hospital of Los Angeles
between 1951 and 1977 for abnormalities of intestinal rotation with or
without volvulus. The mortality in this group of patients was 4% and
represents a significant improvement from the 23% mortality previously
reported from this institution between 1937 and 1951. Neonatal patients had
bilious vomiting and signs of high intestinal obstruction while older
children had a more chronic course characterized by intermittent episodes
of abdominal pain. Evaluation with contrast studies and early celiotomy is
mandatory to prevent bowel necrosis. We outline the associated
gastrointestinal anomalies and management of these combined anomalies.
