Gut malrotation
surgery

What is gut/intestinal malrotation?

The twisting of the intestine leading to a blockage or obstruction is called malrotation.

It mostly affects children and happens during pregnancy when the intestines are not developed in the fetus.

Malrotation can cause the following complication:

Volvulus is a condition where the bowel twists itself and the blood supply to the tissues is cut off, resulting in the damage and death of tissues.

Formation of a condition called ladd’s band which can be life threatening leads to the blockage of duodenum.

Both of the above conditions are life threatening and can lead to damage or death of intestinal tissues, stopping bowel movements etc.

What are the symptoms of

intestinal malrotation?

Following are the signs of intestinal malrotation:

  • Block in the intestine leading to an obstruction of passage of food
  • Cramping leading to the pain in the abdominal region
  • In infants there maybe lethargy and trouble in passing stools
  • Vomiting and nausea ( vomit can be green and yellow in colour)
  • The infant starts crying often without any reason, this can be an indication that the small intestine is blocked
  • Swollen abdomen
  • Diarrhea
  • Blood in the stools
  • Fever
  • Problem in bowel movement with little or no bowel movement
  • Rapid heart rate

How is malrotation

diagnosed?

Imaging scans like CT scan, MRI scan, X rays are helpful in detecting the malrotation.

What are treatments available and

how to prepare for them?

Surgical procedure is a go to treatment to correct malrotation.

The surgery is called ladd procedure, during the surgery the intestine is straightened out, ladd bands are divided and small intestine is placed on to the right side of the abdomen and the colon to the left. The appendix is removed to facilitate this, if the appendix is not removed complications may occur leading to appendicitis.

The doctor will inform the patient about the requirement of having a ‘stoma’ after the surgery.

A stoma is an opening in the belly wall that is made during the surgery by the doctor in order for the waste to leave the body, which doesn’t happen if there is no bowel movement through the rectum.

The waste from the stoma collects in the colostomy bag.

There are two methods of surgery available

Open method, where incisions are made in the abdomen; gradually by making way through the other organs in the abdomen the intestine is reached and the malrotation is corrected.

There is a constant supply of essential nutrients through the IV.

The second method is a Laparoscopic approach or a minimally invasive procedure.

A general anesthesia will be administered to the patient and as a result he/she will be asleep during the surgery.

Once the patient is asleep the process begins by making incisions near the belly button and a small device is inserted which is called a port; it creates an opening that will be filled with gas (carbon dioxide) in the abdomen region.

Through these incisions a Laparoscope (a Laparoscope is a small instrument with a narrow tube which has light source and camera at the end of the tube) is inserted and using the Laparoscope’s video camera the surgeon is able to locate the affected body part and through the other incisions that are made the malrotation is reached and corrected with the help of surgical equipment; during the surgery the appendix is also removed, after this the incisions are sealed using a surgical glue or staples.

The surgery involves small incisions which take very less time to heal and as a result the patient can return back to normal life within no time.

How long does it take to recover from the procedure?

The time taken to heal from an open procedure is little longer than the laparoscopic procedure.

 The recovery time for Laparoscopic surgeries is very less and one can return to normal life within days of surgery, but they should avoid heavy lifting. The soreness after the surgery lasts for 48 hours and it can extend up to weeks depending upon the individual.

If the patient is fine and the pain is less, then he is discharged immediately and follow up checkup is held every 7 to 10 days post discharge.

If the pain in the incisional area persists the doctor will advise bed rest for a week.

One might feel nauseated post-surgery, this might be due to anesthesia administered for the purpose of the surgery.

 Post-surgery one might feel shoulder pain because of the gas that was pumped in during the surgery, which will go away within 48 hours.

The doctor might prescribe a small amount of narcotic pain medicine to relieve pain, but there are cases where this is not required.

When to call a doctor if complications occur
post-surgery?

If one feels nauseated, develops fever, bleeding occurs through the incisions, inability to urinate etc, under these circumstances it is better to get in touch with the doctor who performed the operation.

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