Congenital intestinal malrotation is one of the common digestive tract malformations. This condition can occur at any age but is most frequently seen in newborns. The incidence rate in China is higher than in European and American countries. Due to certain factors affecting intestinal development during the embryonic stage, the normal rotation process of the midgut is interrupted at a certain stage, leading to abnormal intestinal positioning, incomplete attachment of the mesentery, and various forms of intestinal obstruction. This condition is often associated with intestinal volvulus, with an incidence rate of 50-56%. Congenital intestinal malrotation, duodenal atresia or stenosis, and annular pancreas all present as high intestinal obstruction, sometimes making differentiation difficult. Differentiation can only be achieved through gastrointestinal imaging and barium enema. Treatment for this condition is primarily surgical, with conservative management possible in some cases. The cure rate for simple intestinal malrotation is as high as 94%, but when combined with other severe malformations, the cure rate drops to only 37%.

bubble_chart Clinical Manifestations

1. A large amount of vomiting occurs several days or more after birth, with the vomitus containing bile. When combined with volvulus causing complete intestinal obstruction, the vomiting is frequent, copious, and projectile. 2. Generally, there are no specific signs, only upper abdominal distension and fullness, visible gastric peristaltic waves, emaciation, etc. When intestinal strangulation occurs, an abdominal mass may be present.

bubble_chart Diagnosis

1. Postnatal vomiting with bile in the vomitus; 2. Abdominal plain film shows the "double bubble" sign; 3. Barium meal examination reveals abnormal duodenal position or the duodenal-jejunal loop descending vertically on the right side of the abdomen; 4. Barium enema: Abnormal position of the cecum.

1. For mild or asymptomatic cases, conservative treatment can be adopted. 2. For those with obvious symptoms, surgical treatment is recommended.

This disease is a congenital malformation, and the effect of drug treatment is uncertain. For those with mild or no symptoms, the disease progression should be closely observed, and surgical treatment may be considered if necessary. The vast majority of cases require surgical correction of the malformation. Since the surgical treatment of this disease requires high professional technical skills, it is best to seek diagnosis and treatment in a hospital with a pediatric surgery department.

bubble_chart Cure Criteria

1. Cured: Symptoms disappear. 2. Improved: Symptoms are alleviated. 3. Not cured: No change in the condition.