A 14-year-old boy with malrotation, known as twisted intestines, experiencing greenish vomit and excruciating pain due to blockage in the abdomen, has been successfully treated and saved by a team of doctors.
The malrotation is a rarely found in grown-up children and is a congenital anomaly which results from failure of the GI tract to undergo usual counter-clockwise rotation during embryologic development.
As per the health experts, Malrotation may lead to twisting of the intestines, causing blockage of blood supply to the gut, risk of gangrene and complete loss of the small intestine.
The patient who was not able to take his complete meal because of abnormalities underwent emergency surgery at Faridabad Sarvodaya Hospital by a team of experts. The patient was not responding to any medication, and was brought to the hospital with agonizing pain in the abdomen.
"The child presented himself with fever at the hospital and was diagnosed with typhoid. He had intense abdominal pain, so we suspected malrotation as one of the possibilities. This is a medical condition where the intestines twist upon themselves, leading to blockage. It is a very rare occurrence in this age group. The condition needs emergency surgery once diagnosed," said Dr Anand Gupta, Senior Consultant, Paediatrics.
Dr Shweta Kumari Sharma, Consultant, Pediatric Surgery said that the patient was found to have acute intestinal obstruction due to malrotation and midgut volvulus. The child had gone into shock due to falling blood pressure and was having seizure.
"Malrotation with midgut volvulus is a surgeon's nightmare. The three-hour surgery, called Ladd procedure, involved repositioning the intestine to correct the anomaly. The patient's intestine was straightened out, the Ladd's bands were divided, the small intestine was folded into the right side of the abdomen, and the colon was placed on the left side. Resuming blood supply of the whole intestine through denotation saved the child's life. Quick diagnosis and immediate surgery proved to be game changers," said Dr Kumari.
The doctor said "The patient will have to take only liquid and soft diet for a couple of weeks, as it takes time for the intestine to restore the digestive and enzymatic activity. There will be slow and gradual return to a normal diet."
"It is rare to find cases of malrotation and midgut volvulus in teenagers. While asymptomatic malrotationis present in 1 in 500 live births, symptomatic malrotation with midgut volvulus occurs in 1 in 6,000 live births. About 80 per cent of cases of malrotation are detected within the first month of life, so it was surprising to see such a case in a 14-year-old boy," Dr Gupta said.
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