J Korean Pediatr Soc.  1999 Apr;42(4):526-534.

Clinical Profiles and Anatomic Classification of Intestinal Malrotation

• Kim JA
• Ko JS
• Seo JK
• Park KW
• Kim WS
• Kim IO

Abstract

PURPOSE: Intestinal malrotation is a developmental anomaly and may be complicated by volvulus and intestinal necrosis. We performed anatomic classification and compared clinical profiles to understand their relationship.
METHODS
Twenty-eight children were diagnosed as intestinal malrotation at Seoul National University Children's Hospital between Jan. 1980 to Dec. 1995. The patients were classified into 4 groups by age at initial presentation(=x). [group 1 : x<1 week, group 2 : 1 week< OR =x<1 month, group 3 : 1 month< OR =x<1 year, group 4 : 1 year< OR =x] Anatomic classification was performed by radiologic and operative findings.
RESULTS
There were 20 males and 8 females. More than half(15/28) of the patients presented in the first month of life, and most of whom presented with bilous vomiting. Most patients older than 1 year of age presented with recurrent abdominal pain and vomiting. The anatomic classification contained 12 patients of type I, 3 patients of type II(IIA : 1, IIC : 2) and 13 patients of type III(IIIA : 5, IIIB : 8). Volvulus occurred in patients of type I and type IIIA and Ladd's band was a major cause of obstruction in patients of type IIIB. Twenty-six patients underwent operation and most had good outcomes except 3 patients.
CONCLUSION
Intestinal malrotation should be considered in children with chronic abdominal pain and vomiting as well as infants with bilous vomiting. By performing anatomic classification, we can understand more precisely this disease and care for patients more effectively.

Keyword

Intestinal malrotation; Anatomic classification

MeSH Terms

Abdominal Pain
Child
Classification*
Female
Humans
Infant
Intestinal Volvulus
Male
Necrosis
Seoul
Vomiting