Malrotation & Volvulus
Basic Information
Definition
Malrotation is any abnormal rotation or fixation of the intestines as they return from the umbilical cord to the abdomen during early fetal life. The abnormal position and lack of fixation within the abdomen predisposes the infant to volvulus, abnormal twisting of the intestine around the superior mesenteric vessels, and obstruction, often with secondary ischemia and infarction.
Clinical Presentation
• Malrotation may manifest with volvulus, duodenal obstruction, or intermittent abdominal pain or as an incidental finding.
• The development of bilious emesis in a newborn is the classic presentation of volvulus and requires urgent evaluation.
• Physical examination may reveal any of the following: irritability and lethargy, signs of dehydration, ill or toxic appearance, tachycardia, tachypnea, grunting, hypotension, distended abdomen or vague abdominal fullness.
