| Objective: This study collected the clinical data of a group of patients with intestinal malrotation in our hospital.We analyzed the data of the age of onset, clinical manifestations, imaging findings, intraoperative conditions, and the effects of two different surgical treatment, in order to optimize the further understanding of congenital intestinal malrotation, and improve the cure rate.Materials and methods: We collected the clinical data of patients admitted to our hospital and diagnosed with intestinal rotation in surgery during January 2011 and June 2015. SPSS 17.0 was used to analyze the data. Differences between groups were calculated by Mann–Whitney test, chi square test and Fisher’s exact test. The level of significance was set at 0.05.Rusults: 1.General information: 91 cases of congenital intestinal rotation of children including 67 cases of male and 24 of female, among which, 66 cases are of newborn and 25 cases are of non-newborn. There were 66 cases of newborn, 29 days-1 years old 12 cases, 1 years old-3 years old 3 cases,and 3 years old of above 9 cases.2.Clinical manifestations: 81 cases presented vomiting, including 72 bilious vomiting and 9 cases of non-bilious vomiting. 31 cases have abdominal distention. Abdominal pain occurred in 8 cases and bloody stool occurred in 5 cases. 3 cases complained for the findings of digestive tract malformation during prenatal examination. Umbilical mass was the main complaint for 3 cases.3.Imaging examination: the imaging methods used in this study included abdominal plain film in 63 cases, upper gastrointestinal radiography in 70 cases, barium enema in 36 cases, abdominal ultrasound in 36 cases and enhanced CT scan in 2 cases.4.The pathological changes and deformity: 91 cases of intestinal malrotation had duodenal Ladd film oppression, including 56 cases of volvulus and 39 cases of upper jejunum membranous tissue adhesion. 6 cases of intestinal necrosis was found in operation. Combined malformations were found in 32 cases, including congenital heart disease in 8 cases, deformity of digestive system in 24 cases, urinary system malformation in 3 cases, omphalocele in 3 cases and trisomy 21 comprehensive syndrome in 2 cases.5.Operation methods: 69 cases underwent open surgery, and 22 patients underwent laparoscopic Ladd procedure. The mean operation times of the two groups were 86.51 ±34.87 min and 109.77±36.33 min. The average postoperative recovery diet times of the two groups were 6.37 ± 3.10 d and 3.86 ± 1.17 d. The mean postoperative hospital stay was 13.6±6.87 d and 9.90±7.75 d. The difference between the two groups was statistically significant(p < 0.05).6.The prognosis: 4 patients gave up treatment due to various reasons and were confirmed dead eventually, while the remaining 87 cases were survived, including 85 cases cured and 2 cases with short bowel syndrome postoperatively.Conclusion: 1.The incidence of congenital malrotation of intestine is more common in children younger than one year old, especially in newborns.2.Children with intestinal rotation can be combined with other system abnormalities, and the digestive system abnormalities are the most common.3.Upper gastrointestinal radiography is the main examination of intestinal malrotation, and the comprehensive application of different imaging methods can improve the preoperative diagnosis rate of intestinal malrotation.4.Laparoscopic surgery in the treatment of intestinal malrotation has certain advantages, which can shorten the length of hospital stay and postoperative fasting time. |
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