The risk of midgut volvulus in patients with abdominal wall defects: A multi-institutional study.

Document Type

Article

Publication Date

1-1-2017

Identifier

DOI: 10.1016/j.jpedsurg.2016.10.014

Abstract

BACKGROUND: The management of malrotation in patients with congenital abdominal wall defects has varied among surgeons. We were interested in investigating the risk of midgut volvulus in patients with gastroschisis and omphalocele to help determine if these patients may benefit from undergoing a Ladd procedure.

METHODS: A retrospective chart review was performed for all patients managed at three institutions born between 1/1/2000 and 12/31/2008 with a diagnosis of gastroschisis or omphalocele. Patient charts were reviewed through 12/31/2012 for occurrence of midgut volvulus or need for second laparotomy.

RESULTS: Of the 414 patients identified with abdominal wall defects, 299 patients (72%) had gastroschisis, and 115 patients (28%) had omphalocele. The mean gestational age at birth was 36.1±2.3weeks, and the mean birth weight was 2.57±0.7kg. There were a total of 8 (1.9%) cases of midgut volvulus: 3 (1.0%) patients with gastroschisis compared to 5 patients (4.4%) with omphalocele (p=0.04).

CONCLUSIONS: Patients with omphalocele have a greater risk of developing midgut volvulus, and a Ladd procedure should be considered during definitive repair to mitigate these risks.

LEVEL OF EVIDENCE: III; retrospective comparative study.

Journal Title

Journal of pediatric surgery

Volume

52

Issue

1

First Page

26

Last Page

29

MeSH Keywords

Birth Weight; Digestive System Abnormalities; Female; Gastroschisis; Gestational Age; Hernia, Umbilical; Humans; Infant, Newborn; Intestinal Volvulus; Male; Retrospective Studies; Risk Factors

Keywords

Gastroschisis; Ladd procedure; Midgut volvulus; Omphalocele; Babies; Newborn

Comments

LEVEL OF EVIDENCE:

III; retrospective comparative study.

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