Childhood Intestine Rotation Anomalies in Aba, Nigeria

Samuel Chidi Ekpemo; Lisa Eweputanna; Emeka Nkwo

doi:doi:10.11648/j.ass.20190701.11

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Childhood Intestine Rotation Anomalies in Aba, Nigeria

Samuel Chidi Ekpemo, Lisa Eweputanna, Emeka Nkwo

Published in Advances in Surgical Sciences (Volume 7, Issue 1)

Received: 23 November 2018 Accepted: 21 January 2019 Published: 7 February 2019

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Abstract

Background: The anomalies of rotation, migration and fixation of the intestines are of intense interest to the pediatric surgeon, as they are frequently associated with midgut volvulus which has catastrophic consequences when diagnosis is delayed or even not considered. This study evaluates the outcomes of surgical management of intestinal malrotation in children. Materials and Methods: The medical records of all patients with symptomatic malrotation, who underwent surgery between January 2010 and September 2018, were reviewed. Patients' demographic characteristics, clinical features management, complications, and outcome were evaluated. Results: Ten patients (nine boys and a girl) underwent surgery for malrotation at a median age of 3months. Eight presented with acute symptoms and two with chronic symptoms. All the patients had symptoms of intermittent or complete upper intestinal obstruction, and malrotation was documented by an upper gastrointestinal contrast study in six of them. Volvulus was found at the time of surgery in 5 patients, three of whom were neonates. Eight patients were treated by Ladd's operation. Median length of stay was 10 days. One patient with massive bowel gangrene due to volvulus had right hemicolectomy. There was two perioperative death from anastomostic leak and septicaemia with an overall mortality of 20%. Conclusion: Bowel gangrene from volvulus contributes to mortality and small bowel adhesive intestinal obstruction is a cause of morbidity and mortality following surgery for intestinal malrotation. Neonates with bilious vomiting should raise the suspicion of malrotation until proven otherwise and given prompt intervention.

Published in	Advances in Surgical Sciences (Volume 7, Issue 1)
DOI	10.11648/j.ass.20190701.11
Page(s)	1-4
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Childhood, Intestine, Rotation, Anomalies

References

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[2]	Filston HC, Kirk DR. Malrotation, the ubiquitous anomaly. J pediatr Surg 1981; 16:614-620.
[3]	Dott NM. Anomalies of intestinal rotation: their embryology and surgical aspects with report of 5 cases. Br J Surg 1923; 11: 253-286
[4]	Ladd WE. Congenital obstruction of the duodenum in children. N Engl J Medicine 1932;206:297-283.
[5]	Gross E, Chen MK, Lobe TE: Laparoscopic evaluation and treatment of intestinal malrotation in infants. Surg Endosc 1996;10:936-937.
[6]	Strouse PJ. Disorders of intestinal rotation and fixation (“malrotation”). Pediatr Radiol 2004; 34:837–851
[7]	Amah CC, Agugua-Obianyo NEN, Ekenze SO. Intestinal malrotation in the older child: common diagnostic pitfalls. W Afr J Radiol 2004; 11:33–37
[8]	Ameh EA, Chirdan LB. Intestinal Malrotation: Experience in Zaria, Nigeria. WAJM 2001; 20, 227-30
[9]	Torres AM, Ziegler MM. Malrotation of the Intestine. World J Surg. 1993;17: 326-
[10]	Ameh EA, Nmadu PT. Intestinal volvulus:aetiology,morbidity and mortality in Nigerian children.Pediatr Surg Int 2000;16:50-52.
[11]	Reyes J, Bueno J, Kocoshis S, et al: Current status of intestinal transplantation in children. J Pediatr Surg 1998;33:243-254.
[12]	Bonadio WA, Clarkson T, Naus J. The clinical features of children with malrotation of the intestine. Pediatr Emerg Care 1991; 7:349
[13]	Rescorla FJ, Shedd FJ, Grosfeld JL, Vane DW, West KW: Anomalies of intestinal rotation in childhood: anomalies of 447 cases. Surgery 1990; 108:710-716.
[14]	Prarcos D, Sann L, Gein G, et al: Ultrasound diagnosis of midgut volvulus: the whirlpool sign. Pediatr Radiol 1992;22:18-20.
[15]	Dufour D, Delaet MH, Dassonville M, Cadranel S, Perlmutter N: Midgut malrotation, the reliability of sonographic diagnosis. Pediatr Radiol 1992; 22:21-23
[16]	Ashley LM, Allen S, Teele RL: A normal sonogram does not exclude malrotation. Pediatr Radiol 2001; 31:354-356.
[17]	Waugh GEA: The morbid consequences of a mobile ascending colon. Br J Surg 1920; 7:343,
[18]	Brerefon RJ, Taylor B, Hall CM: Intussception and intestinal malrotation in infants: Waugh’s syndrome. Br J Surg 1986; 73:55-57.
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[20]	Schwartz DL, So HB, Schneider KM, Becker JM: Recurrent chylous ascites associated with intestinal malrotation and lymphatic rupture. J Pediatr Surg 1983; 18:177-179.
[21]	Stauffer UG, Hermann P: Comparison of late results in patients with corrected intestinal malrotation with and without ﬁxation of the mesentery. J Pediatr Surg1980; 15:1.
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APA Style

Samuel Chidi Ekpemo, Lisa Eweputanna, Emeka Nkwo. (2019). Childhood Intestine Rotation Anomalies in Aba, Nigeria. Advances in Surgical Sciences, 7(1), 1-4. https://doi.org/10.11648/j.ass.20190701.11

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ACS Style

Samuel Chidi Ekpemo; Lisa Eweputanna; Emeka Nkwo. Childhood Intestine Rotation Anomalies in Aba, Nigeria. Adv. Surg. Sci. 2019, 7(1), 1-4. doi: 10.11648/j.ass.20190701.11

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AMA Style

Samuel Chidi Ekpemo, Lisa Eweputanna, Emeka Nkwo. Childhood Intestine Rotation Anomalies in Aba, Nigeria. Adv Surg Sci. 2019;7(1):1-4. doi: 10.11648/j.ass.20190701.11

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@article{10.11648/j.ass.20190701.11,
  author = {Samuel Chidi Ekpemo and Lisa Eweputanna and Emeka Nkwo},
  title = {Childhood Intestine Rotation Anomalies in Aba, Nigeria},
  journal = {Advances in Surgical Sciences},
  volume = {7},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.ass.20190701.11},
  url = {https://doi.org/10.11648/j.ass.20190701.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20190701.11},
  abstract = {Background: The anomalies of rotation, migration and fixation of the intestines are of intense interest to the pediatric surgeon, as they are frequently associated with midgut volvulus which has catastrophic consequences when diagnosis is delayed or even not considered. This study evaluates the outcomes of surgical management of intestinal malrotation in children. Materials and Methods: The medical records of all patients with symptomatic malrotation, who underwent surgery between January 2010 and September 2018, were reviewed. Patients' demographic characteristics, clinical features management, complications, and outcome were evaluated. Results: Ten patients (nine boys and a girl) underwent surgery for malrotation at a median age of 3months. Eight presented with acute symptoms and two with chronic symptoms. All the patients had symptoms of intermittent or complete upper intestinal obstruction, and malrotation was documented by an upper gastrointestinal contrast study in six of them. Volvulus was found at the time of surgery in 5 patients, three of whom were neonates. Eight patients were treated by Ladd's operation. Median length of stay was 10 days. One patient with massive bowel gangrene due to volvulus had right hemicolectomy. There was two perioperative death from anastomostic leak and septicaemia with an overall mortality of 20%. Conclusion: Bowel gangrene from volvulus contributes to mortality and small bowel adhesive intestinal obstruction is a cause of morbidity and mortality following surgery for intestinal malrotation. Neonates with bilious vomiting should raise the suspicion of malrotation until proven otherwise and given prompt intervention.},
 year = {2019}
}

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TY - JOUR
T1 - Childhood Intestine Rotation Anomalies in Aba, Nigeria
AU - Samuel Chidi Ekpemo
AU - Lisa Eweputanna
AU - Emeka Nkwo
Y1 - 2019/02/07
PY - 2019
N1 - https://doi.org/10.11648/j.ass.20190701.11
DO - 10.11648/j.ass.20190701.11
T2 - Advances in Surgical Sciences
JF - Advances in Surgical Sciences
JO - Advances in Surgical Sciences
SP - 1
EP - 4
PB - Science Publishing Group
SN - 2376-6182
UR - https://doi.org/10.11648/j.ass.20190701.11
AB - Background: The anomalies of rotation, migration and fixation of the intestines are of intense interest to the pediatric surgeon, as they are frequently associated with midgut volvulus which has catastrophic consequences when diagnosis is delayed or even not considered. This study evaluates the outcomes of surgical management of intestinal malrotation in children. Materials and Methods: The medical records of all patients with symptomatic malrotation, who underwent surgery between January 2010 and September 2018, were reviewed. Patients' demographic characteristics, clinical features management, complications, and outcome were evaluated. Results: Ten patients (nine boys and a girl) underwent surgery for malrotation at a median age of 3months. Eight presented with acute symptoms and two with chronic symptoms. All the patients had symptoms of intermittent or complete upper intestinal obstruction, and malrotation was documented by an upper gastrointestinal contrast study in six of them. Volvulus was found at the time of surgery in 5 patients, three of whom were neonates. Eight patients were treated by Ladd's operation. Median length of stay was 10 days. One patient with massive bowel gangrene due to volvulus had right hemicolectomy. There was two perioperative death from anastomostic leak and septicaemia with an overall mortality of 20%. Conclusion: Bowel gangrene from volvulus contributes to mortality and small bowel adhesive intestinal obstruction is a cause of morbidity and mortality following surgery for intestinal malrotation. Neonates with bilious vomiting should raise the suspicion of malrotation until proven otherwise and given prompt intervention.
VL - 7
IS - 1
ER -

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Author Information

Samuel Chidi Ekpemo

Department of Surgery, Abia State University, Aba, Nigeria
Lisa Eweputanna

Department of Radiology, Abia State University, Aba, Nigeria
Emeka Nkwo

Department of Obstetrics and Gynaecology, Federal Medical Center, Umuahia, Nigeria

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Plain Text BibTeX RIS

APA Style

Samuel Chidi Ekpemo, Lisa Eweputanna, Emeka Nkwo. (2019). Childhood Intestine Rotation Anomalies in Aba, Nigeria. Advances in Surgical Sciences, 7(1), 1-4. https://doi.org/10.11648/j.ass.20190701.11

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ACS Style

Samuel Chidi Ekpemo; Lisa Eweputanna; Emeka Nkwo. Childhood Intestine Rotation Anomalies in Aba, Nigeria. Adv. Surg. Sci. 2019, 7(1), 1-4. doi: 10.11648/j.ass.20190701.11

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AMA Style

Samuel Chidi Ekpemo, Lisa Eweputanna, Emeka Nkwo. Childhood Intestine Rotation Anomalies in Aba, Nigeria. Adv Surg Sci. 2019;7(1):1-4. doi: 10.11648/j.ass.20190701.11

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@article{10.11648/j.ass.20190701.11,
  author = {Samuel Chidi Ekpemo and Lisa Eweputanna and Emeka Nkwo},
  title = {Childhood Intestine Rotation Anomalies in Aba, Nigeria},
  journal = {Advances in Surgical Sciences},
  volume = {7},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.ass.20190701.11},
  url = {https://doi.org/10.11648/j.ass.20190701.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20190701.11},
  abstract = {Background: The anomalies of rotation, migration and fixation of the intestines are of intense interest to the pediatric surgeon, as they are frequently associated with midgut volvulus which has catastrophic consequences when diagnosis is delayed or even not considered. This study evaluates the outcomes of surgical management of intestinal malrotation in children. Materials and Methods: The medical records of all patients with symptomatic malrotation, who underwent surgery between January 2010 and September 2018, were reviewed. Patients' demographic characteristics, clinical features management, complications, and outcome were evaluated. Results: Ten patients (nine boys and a girl) underwent surgery for malrotation at a median age of 3months. Eight presented with acute symptoms and two with chronic symptoms. All the patients had symptoms of intermittent or complete upper intestinal obstruction, and malrotation was documented by an upper gastrointestinal contrast study in six of them. Volvulus was found at the time of surgery in 5 patients, three of whom were neonates. Eight patients were treated by Ladd's operation. Median length of stay was 10 days. One patient with massive bowel gangrene due to volvulus had right hemicolectomy. There was two perioperative death from anastomostic leak and septicaemia with an overall mortality of 20%. Conclusion: Bowel gangrene from volvulus contributes to mortality and small bowel adhesive intestinal obstruction is a cause of morbidity and mortality following surgery for intestinal malrotation. Neonates with bilious vomiting should raise the suspicion of malrotation until proven otherwise and given prompt intervention.},
 year = {2019}
}

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