Intestinal malrotation is a congenital anomaly . The children are born with abnormal position of gut as a result of incomplete or non rotation of gut during embryogenesis.This can predispose to midgut volvulus(strangulation of malrotated gut) and internal hernias, and can result in life-threatening complications. Although some individuals live their entire life with malrotated bowel without symptoms.
The abnormal rotation of gut is charecterised with:
- The small bowel is present on the right side of the abdomen
- The cecum is displaced to epigastrium – right hypochondrium
- The ligament of Treitz is displaced inferiorly and rightward
- Fibrous bands (of Ladd) course over the vertical portion of the duodenum (DII), causing intestinal obstruction.
- The small intestine have an unusually narrow base, and therefore the midgut is prone to volvulus and cause intestinal ischemia.
Signs and symptoms
Patients (often infants) present acutely with midgut volvulus, manifested by bilious vomiting, crampy abdominal pain, abdominal distention, and the passage of blood and mucus in their stools. Patients with chronic, uncorrected malrotation can have recurrent abdominal pain and vomiting.
Malrotation can also be asymptomatic.
This can lead to a number of disease manifestations such as:
- Acute midgut volvulus
- Chronic midgut volvulus
- Acute duodenal obstruction
- Chronic duodenal osbstruction
- Internal herniation
- Superior mesenteric artery syndrome