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Clinical Profiles and Anatomic Classification of Intestinal Malrotation

Journal of the Korean Pediatric Society 1999;42(4):526-534.
Published online April 15, 1999.
Clinical Profiles and Anatomic Classification of Intestinal Malrotation
Jung A Kim1, Jae Seong Ko1, Jeong Kee Seo1, Kwi Won Park2, Woo Sun Kim3, In One Kim3
1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
2Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Korea
3Department of Pediatric Radiology, Seoul National University College of Medicine, Seoul, Korea
장 이상회전의 해부학적 분류 및 임상양상에 관한 고찰
김정아1, 고재성1, 서정기1, 박귀원2, 김우선3, 김인원3
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 소아외과학교실
3서울대학교 의과대학 소아방사선과학교실
Correspondence: 
Jeong Kee Seo, Email: 1
Abstract
Purpose
: Intestinal malrotation is a developmental anomaly and may be complicated by volvulus and intestinal necrosis. We performed anatomic classification and compared clinical profiles to understand their relationship.
Methods
: Twenty-eight children were diagnosed as intestinal malrotation at Seoul National University Children's Hospital between Jan. 1980 to Dec. 1995. The patients were classified into 4 groups by age at initial presentation(=x). [group 1 : x<1 week, group 2 : 1 week≤x<1 month, group 3 : 1 month≤x<1 year, group 4 : 1 year≤x] Anatomic classification was performed by radiologic and operative findings.
Results
: There were 20 males and 8 females. More than half(15/28) of the patients presented in the first month of life, and most of whom presented with bilous vomiting. Most patients older than 1 year of age presented with recurrent abdominal pain and vomiting. The anatomic classification contained 12 patients of type Ⅰ, 3 patients of type Ⅱ(ⅡA : 1, ⅡC : 2) and 13 patients of type Ⅲ(ⅢA : 5, ⅢB : 8). Volvulus occurred in patients of type I and type ⅢA and Ladd's band was a major cause of obstruction in patients of type ⅢB. Twenty-six patients underwent operation and most had good outcomes except 3 patients.
Conclusion
: Intestinal malrotation should be considered in children with chronic abdominal pain and vomiting as well as infants with bilous vomiting. By performing anatomic classification, we can understand more precisely this disease and care for patients more effectively.
Key Words: Intestinal malrotation, Anatomic classification


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