Malrotation is a topic covered in the 5-Minute Emergency Consult.

To view the entire topic, please or purchase a subscription.

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:

Emergency Central

-- The first section of this topic is shown below --

Basics

Description

  • Incomplete rotation and fixation of intestine during embryogenesis during transition from extracolonic position during week 10 of gestation
  • Risk factor:
    • Heterotaxia syndromes
  • Associated conditions:
    • Gastrointestinal anomalies:
      • Duodenal stenosis, atresia, web
      • Meckel diverticulum
      • Intussusception
      • Gastroesophageal reflux
      • Omphalocele or gastroschisis
      • Congenital diaphragmatic hernia
      • Abdominal wall defect
      • Hirschsprung disease
    • Metabolic acidosis
    • Congenital cardiac anomalies; present in 27% of patients with malrotation; increases morbidity to 61%

Etiology

  • Duodenojejunal junction remains right of midline
  • Cecum remains in the upper left abdomen with abnormal mesenteric attachments
  • Volvulus is complication of malrotation when small bowel rotates around superior mesenteric artery and vein resulting in vascular compromise to midgut
  • Abnormal anatomy predisposes to obstruction and other conditions
  • Usually found in combination with other congenital anomalies (70%): Cardiac, esophageal, urinary, anal
  • Epidemiology:
    • 1 in 500 live births
    • High mortality in infants: Up to 24%
    • Necrotic bowel at surgery increases mortality by 25×.
    • Incidence:
      • In neonates, male-to-female ratio 2:1
      • 75% diagnosed newborn period
      • 90% diagnosed by age 1 yr of life
      • Can present during adulthood

-- To view the remaining sections of this topic, please or purchase a subscription --

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Malrotation ID - 307276 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307276/all/Malrotation ER -