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Intestinal malrotation is a congenital anomaly of rotation of the midgut. It occurs during the first trimester as the fetal gut undergoes a complex series of growth and development. Malrotation can lead to a dangerous complication called volvulus, in which cases emergency surgery is indicated. [1]
Screening can be performed with an upper GI series. The most severe complication of malrotation is midgut volvulus, in which the mesenteric base twists around the superior mesenteric artery, compromising intestinal perfusion, leading to bowel necrosis. A surgical operation called a "Ladd procedure" is performed to alleviate intestinal malrotation.
Midgut volvulus occurs in people (usually babies) that are predisposed because of congenital intestinal malrotation. Segmental volvulus occurs in people of any age, usually with a predisposition because of abnormal intestinal contents (e.g. meconium ileus) or adhesions.
Malrotation of the midgut during development can lead to volvulus. Pain in the midgut is referred to the region around the belly button; As stated, in development a loop of midgut herniates outside of the abdominal cavity into the umbilical cord. If this persists after birth it is called an omphalocele.
After surgery a child with omphalocele will have some degree of intestinal malrotation. Due to intestinal malrotation 4.4% of children with omphalocele will experience a midgut volvulus in the days, months, or years after surgery. Parents of children with omphalocele should seek immediate medical attention if their child displays signs and ...
Frontal view of the abdomen with double bubble sign, patient was found to have duodenal atresia. In radiology, the double bubble sign is a feature of pediatric imaging seen on radiographs or prenatal ultrasound in which two air filled bubbles are seen in the abdomen, representing two discontiguous loops of bowel in a proximal, or 'high,' small bowel obstruction.
In the 10th week, it returns into the abdominal cavity. While these processes are occurring, the midgut loop rotates 270° counterclockwise. Common abnormalities at this stage of development include remnants of the vitelline duct, failure of the midgut to return to the abdominal cavity, malrotation, stenosis, and duplication of parts. [6]
The gastrointestinal tract and associated dorsal mesentery are subdivided into foregut, midgut, and hindgut regions based on the respective blood supply. The foregut is supplied by the celiac trunk, the midgut is supplied by the superior mesenteric artery (SMA), and the hindgut is supplied by the inferior mesenteric artery (IMA).