What is intestinal malrotation?
Failure of normal rotation 270 clockwise rotation around sma
position of the gut in malrotation
deudenojejunal limb in right -hemiabdomen and cecocolic in the left hemiabdomen
model of midgut malrotation (4)
1-herniation
2- rotation
3-retraction
4-fixation
cardinal sign of io in malrotation
sudden onset of billious vomiting
if there is vascular comprimise to obstructed bowel what will happen
progressive abd distention until perotinitis occur
late symptoms of intestinal malrotation
abdominal wall erythema and shock
what are the main investigations for mal rotation
plain ap xray +lateral
color doppler us (inversion of sma and vein )
gold standard investigations for mal rotation
upper gi contrast
showing coil spring , corckscrew, beak apperance
what is the imp preop management of mal rotation
-treat dehydration and electrolyte imbalances
-agressive resusitation and decompression
mention the name of operation used in mal rotation and describe it
lads procedure
-open approach
-conter clock wise detorsion
- division of lads ceacal bands
- broaden mesentyand appendectomy
- place small bowel in rt and colon in lft
if there is non viable intestine in ttt of mal rotation what to do
resect and anastomosis +- stoma
complications of mal rotation
death , short bowel syndrome , adhesive intestinal obs
