Clinical Profiles and Anatomic Classification of Intestinal Malrotation.
- Author:
Jung A KIM
1
;
Jae Seong KO
;
Jeong Kee SEO
;
Kwi Won PARK
;
Woo Sun KIM
;
In One KIM
Author Information
1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Intestinal malrotation;
Anatomic classification
- MeSH:
Abdominal Pain;
Child;
Classification*;
Female;
Humans;
Infant;
Intestinal Volvulus;
Male;
Necrosis;
Seoul;
Vomiting
- From:Journal of the Korean Pediatric Society
1999;42(4):526-534
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Intestinal malrotation is a developmental anomaly and may be complicated by volvulus and intestinal necrosis. We performed anatomic classification and compared clinical profiles to understand their relationship. METHODS: Twenty-eight children were diagnosed as intestinal malrotation at Seoul National University Children's Hospital between Jan. 1980 to Dec. 1995. The patients were classified into 4 groups by age at initial presentation(=x). [group 1 : x<1 week, group 2 : 1 week< OR =x<1 month, group 3 : 1 month< OR =x<1 year, group 4 : 1 year< OR =x] Anatomic classification was performed by radiologic and operative findings. RESULTS: There were 20 males and 8 females. More than half(15/28) of the patients presented in the first month of life, and most of whom presented with bilous vomiting. Most patients older than 1 year of age presented with recurrent abdominal pain and vomiting. The anatomic classification contained 12 patients of type I, 3 patients of type II(IIA : 1, IIC : 2) and 13 patients of type III(IIIA : 5, IIIB : 8). Volvulus occurred in patients of type I and type IIIA and Ladd's band was a major cause of obstruction in patients of type IIIB. Twenty-six patients underwent operation and most had good outcomes except 3 patients. CONCLUSION: Intestinal malrotation should be considered in children with chronic abdominal pain and vomiting as well as infants with bilous vomiting. By performing anatomic classification, we can understand more precisely this disease and care for patients more effectively.
