Intestinal malrotation

Abstract

Intestinal malrotation comprises a spectrum of congenital anomalies due to aberrant intestinal rotation and fixation of the gut occurring during prenatal development. The symptoms and signs of intestinal malrotation may manifest at any age, but most affected individuals present in infancy, typically with bilious vomiting. Failure to diagnose and treat the condition promptly can result in fatal midgut volvulus. Intestinal malrotation may occur in isolation or be associated with other congenital anomalies. In 1936, the North American surgeon, William Ladd, emphasized the importance of surgical treatment, and his operation (Ladd procedure) remains the definitive treatment today. Recent advances include an improved understanding of the clinical situations in which intestinal malrotation is better managed expectantly rather than by surgery, the role of laparoscopy in diagnosis and treatment, and potentially life-saving therapy to treat midgut ischemia associated with volvulus.