Malrotation

Intestinal malrotation comprises the spectrum of abnormalities of midgut development associated with abnormal rotation and/or fixation. Intestinal malrotation is characterized by the congenital abnormal positioning of the midgut, narrowing the dorsal mesenteric root and putting the bowel at risk of midgut volvulus. It is usually associated to the presence of peritoneal folds, the Ladd’s bands, which cross from the colon and cecum to the duodenum and liver and can cause duodenal obstruction. Patients with intestinal malrotation can remain asymptomatic or may present with signs of acute bowel obstruction, such as colicky abdominal pain, abdominal distention, bilious vomiting, or shock. The surgical treatment is the Ladd’s procedure with derotation of the volvulus, division of the Ladd’s bands, widening of the small intestine’s mesentery, appendectomy, and correctional placement of the cecum and colon.