Association of Malrotation with Intussusception: Experience in Chittagong, Bangladesh

Posted by Jafrul Hannan on Fri, Feb 19, 2010  
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Aims & Objectives: Intussusception is a common cause of bowel obstruction in children. Although many causes have been described, malrotation is not included in the list. This study was done to find out if there is any relation/association between intussusception and malrotation.

Methods: A retrospective review of intussusception patients were performed from January 2000 to Jan 2004 at a tertiary centre. Total 153 children were treated. Out of them 94 underwent laparotomy and surgical reduction. Patients were identified that had features of malrotation.

Results: Total 61 patients were studied. Age ranged from 4 months to 19 months (Mean 5.88 ± 2.62 months). M: F is 3: 2. After reduction of intussusception cecum (C) was found at or near midline in 22 patients, right hypochondrium in 16, left hypochondrium in 23.  Bands were noted from cecum to gall bladder in 9, liver border in 4, and posterior abdominal wall in 5 patients. Resection & anastomosis (R & A) was needed in 28 patients. Five (8.2%) patients expired. No recurrence occurred till now.

Conclusions: Malrotation (mobile cecum) may be a cause of intussusception. Also this makes the reduction, R & A easier. More studies are needed to reach a definite conclusion.

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