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Intestinal malrotation

INTRODUCTION

Rotational anomalies occur as a result of an arrest of normal rotation of the embryonic gut. They are often associated with other gastrointestinal abnormalities, particularly those in which the intestines are located outside the coelomic cavity (eg, congenital diaphragmatic hernia or abdominal wall defects). However, intestinal malrotation can also occur in children and adults who have no associated anomalies.

An overview of the presentation, diagnosis, and treatment of intestinal malrotation will be presented here. Congenital diaphragmatic hernia and abdominal wall defects are discussed separately. (See "Omphalocele".)

EPIDEMIOLOGY

Rotational anomalies, which may or may not be symptomatic, are estimated to occur in between 1 in 200 and 1 in 500 live births [1,2]. Symptomatic malrotation is estimated to occur in 1 in 6000 live births [3]. Traditionally, intestinal malrotation has been considered primarily a disease of infancy with infrequent occurrence beyond the first year of life. However, analysis of 2744 cases of intestinal rotation in children up to 17 years of age obtained from a national hospital discharge database found the following [4]:

Presentation by one month of age: 30 percent

Presentation before one year of age: 58 percent

                             

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Literature review current through: Nov 2014. | This topic last updated: Oct 24, 2014.
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