pediatrics
Malrotation of the Bowel
Treatment of Malrotation of the Bowel
Surgical repair The presence of malrotation and midgut volvulus is an emergency requiring immediate surgery, which is a Ladd procedure with lysis of the retroperitoneal bands and relief of the midgut volvulus. The Ladd procedure can be done laparoscopically or as an open procedure. Doing the Ladd procedure laparoscopically for malrotation without volvulus may decrease the time until enteral nutrition is reintroduced and reduce the length of hospital stay compared to an open procedure ( Treatment reference ). When malrotation is found incidentally in an asymptomatic child, the Ladd procedure should be considered given the potentially devastating outcome of a volvulus; however, doing this procedure in this situation is controversial. 1.Ooms N, Matthyssens LE, Draaisma JM, et al: Laparoscopic treatment of intestinal malrotation in children.Eur J Pediatr Surg26:376–381, 2016. doi: 10.1055/s-0035-1554914 