All issues > Volume 42(4); 1999

Original Article

J Korean Pediatr Soc. 1999;42(4):526-534. Published online April 15, 1999.

Clinical Profiles and Anatomic Classification of Intestinal Malrotation

Jung A JA Kim¹, Jae Seong JS Ko¹, Jeong Kee JK Seo¹, Kwi Won KW Park², Woo Sun WS Kim³, In One IO Kim³

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
²Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea
³Department of Pediatric Radiology, Seoul National University College of Medicine, Seoul, Korea

Correspondence Jeong Kee JK Seo ,Email: 1

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≤x<1 month, group 3 : 1 month≤x<1 year, group 4 : 1 year≤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.

Keywords :Intestinal malrotation, Anatomic classification