Malrotation
Gastroenterology
Normal rotation is 270deg counterclockwise (looking at patient) around the superior mesenteric artery
Completed ~3m gestation
Presentation
Bile-stained vomiting
Abdominal distension
Abdominal pain
Peritonitis
Haematochezia
Shock
0-1m: 15%
1m-1y: 15%
1-5y: 6%
5-18y: 12%
>18y: 50%
Ix
Unstable > Exploratory OT post resuscitation fluids/ABs
Stable > Xray > perforation ^ as above
no perforation > Upper GIT contrast
- look for duodenum misplaced/beaked/corkscrew/obstruction
Negative > ?lower barium enema
Normal rotation is 270deg counterclockwise (looking at patient) around the superior mesenteric artery
Completed ~3m gestation
Presentation
Bile-stained vomiting
Abdominal distension
Abdominal pain
Peritonitis
Haematochezia
Shock
0-1m: 15%
1m-1y: 15%
1-5y: 6%
5-18y: 12%
>18y: 50%
Ix
Unstable > Exploratory OT post resuscitation fluids/ABs
Stable > Xray > perforation ^ as above
no perforation > Upper GIT contrast
- look for duodenum misplaced/beaked/corkscrew/obstruction
Negative > ?lower barium enema