MALROTN

Malrotation of the midgut with volvulus is a surgical
emergency. If not treated promptly, ischemic
gangrene of the small intestine develops rapidly. In
80% of malrotations, symptoms will develop
within the first month of life. The typical presentation
is with sudden onset of bilious vomiting with
or without bloody stools in a previously well
neonate with only minimal other physical findings.
Sometimes, pain or a shock-like syndrome is present.
The diagnosis is made by an upper GI series.
Barium enema has a 10–20% rate of false-negative
results because of normally positioned cecum.
When suspected, the infant should undergo prompt
surgical exploration and treatment.