Malrotation

An understanding of abnormalities of rotation and fixation are important problems for the pediatric population and occasionally for the adult population. For the newborn with bilious emesis, emergent evaluation and operative correction may be lifesaving. In other patients with symptoms of intermittent duodenal obstruction, abdominal pain, early satiety, diarrhea, or unexplained weight loss, a high index of suspicion should be present for the possibility of malrotation, and an upper gastrointestinal series should be performed. Operative correction of rotation and fixation anomalies is successful in most patients, but overall morbidity and mortality rates are influenced mostly by the swiftness of diagnosis and operative intervention. It is for this reason that the general surgeon, who may be the first and only surgeon available for the examination of the pediatric patient with malrotation, have a thorough understanding of the disease and a high index of suspicion.