Intestinal malrotation in the newborn

Giving your baby a health check is an essential thing. Many parents will find that their baby’s intestinal rotation is malfunctioning, but they don’t know what’s going on. As the name suggests, the rotational movement of the baby's intestines and superior mesenteric artery is impaired. This is a congenital disease. If not treated in time, it may threaten the baby's life, so it must be treated in time. And the safety factor of surgical treatment is also very high, just pay more attention.

①Basic concepts

Congenital intestinal malrotation is caused by abnormal rotational movement of the intestine around the superior mesenteric artery during embryonic development, which causes variations in the position of the intestine, incomplete mesenteric attachment and abnormal peritoneal cords, leading to lesions such as compression of the duodenum and jejunum and intestinal torsion. It is a common cause of congenital intestinal obstruction in infants and young children.

Simply put, when the baby's intestines are formed in the mother's belly, their position changes, causing compression of the duodenum, resulting in repeated vomiting. Surgery is needed to help relieve the obstruction and straighten the intestines.

②Incidence

Intestinal malrotation is the most common cause of duodenal obstruction, with an incidence of 1/6000, ranking first among the three common causes. About 0.2% of the normal population has undetected intestinal spiraling, and these people have it for life because they have no symptoms. 55% of intestinal malrotation occurs within 1 week after birth, and 80% within 1 month. The male to female ratio is 2:1.

③Clinical manifestations

The most common symptom is repeated and frequent bilious vomiting (vomiting yellow-green liquid). If the abdominal X-ray after birth shows the "double bubble sign", the disease should be suspected. Upper gastrointestinal tract radiography and B-ultrasound can clarify the specific cause of obstruction.

④Surgical method

Ladd surgery is the classic method for treating this disease. With the development of laparoscopic technology, laparoscopic surgery is gradually being used to treat congenital malformations in newborns.

⑤Comparison between laparoscopic surgery and traditional surgery

The fundamental difference between laparoscopic surgery and traditional surgery lies in the different surgical approaches. After entering the abdominal cavity, the surgical method is the classic Ladd procedure. In the past, the traditional surgical approach was a 4-6 cm transverse incision through the right upper abdomen, which required cutting the abdominal wall and destroying the physiological structure. In particular, it required cutting the rectus abdominis muscle, which caused severe damage, heavy bleeding, obvious pain, and slow recovery. Laparoscopic surgery does not require cutting the abdominal wall. Only three small holes are made in the abdominal wall to place laparoscopic instruments. It causes less trauma, less bleeding, less pain, quick recovery, and very obvious cosmetic effects. The wound is basically invisible after one month.

⑥Prognosis

The prognosis of this disease is good. According to the statistics of the Neonatal Surgery Department of Guangdong Provincial Women and Children's Health Care Hospital in the past five years, the cure rate can reach 99%. The vast majority of babies have no abnormal symptoms after surgery and grow and develop well, just like normal babies.