Comparative Analyses of Intestinal Malrotations Between Neonates/Infants and Children Over One Year of Age

Abstract

Purpose: To identify the characteristics of malrotation, we compared a group of neonates and infants with malrotation and a group of older children (>1 year of age) with malrotation.

Method: Patients with malrotation and who were treated in our institution from January 1990 to December 2015 were retrospectively analyzed. The patients were divided into two groups: Group (A), for those less than one year of age (neonatal and infantile group), and Group (B), for those more than one year of age (older children group). Backgrounds, symptoms, period of symptoms, midgut volvulus, operative procedures, operative time, intraoperative bleeding, and postoperative complications were compared.

Result: The number of patients of interest was 45: Group (A) consisting of 38 patients, and Group (B), 7 patients. Comparison of symptoms showed bilious vomiting as the predominant symptom in Group (A), and nonbilious vomiting and intermittent abdominal pain as the major symptoms in Group (B). Midgut volvulus comparison showed no significant difference between the two groups, but chronic midgut volvulus was suspected in Group (B). Operative time was statistically significantly longer and intraoperative bleeding was significantly larger in volume in Group (B) than in Group (A). There were no significant differences in postoperative complications between the groups, and adhesive ileus was more common in Group (B) than in Group (A).

Conclusion: The characteristics of malrotation in older children were clearly different from those in neonates and infants. It is important that older children with chronic gastrointestinal symptoms be examined for intestinal malrotation.