Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: Feb 13 2018


  • Snapshot
    • A 2-day-old neonate presents with bilious vomiting and irritability. On physical examination, she has abdominal distention and high-pitched bowel sounds. Barium enema radiograph reveals a dilated sigmoid colon with a column of barium resembling a "coffee bean".
  • Introduction
    • Malrotation of gut from errors during development increases risk of volvulus
    • Volvulus (typically, midgut)
      • abnormal rotation of bowel
      • strangulation of SMA
      • compromised blood flow to bowel
    • Epidemiology
      • most common in newborns
      • males > females
    • Associated conditions
      • situs inversus
      • cardiovascular defects
      • heterotaxy
      • gastroschisis/omphalocele
  • Presentation
    • Symptoms
      • neonates
        • bilious vomiting within first week of life
        • colicky pain
      • older patients
        • bilious or nonbilious vomiting
        • crampy abdominal pain
        • change in bowel pattern
        • nausea
    • Physical exam
      • abdominal distention
      • abdominal tenderness
  • Evaluation
    • abdominal radiography
      • may have air fluid levels
    • upper GI imaging with barium enema
      • “bird beak” appearance at site of rotation
      • failure of duodenum to cross midline = malrotation
  • Differential Diagnosis
    • Intussusception
    • Intestinal atresia
    • Gastroenteritis
    • Appendicitis
    • Meckel diverticulum
  • Treatment
    • Malrotation without volvulus
      • elective Ladd procedure
    • Malrotation with volvulus (symptomatic or acute abdomen)
      • emergent endoscopic decompression
      • surgical decompression
  • Prognosis, Prevention, and Complications
    • Prognosis
      • good with treatment
    • Complications
      • bowel necrosis
      • perforation
      • sepsis
1 of 0
1 of 1
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options