When Your Child Has Intestinal Malrotation

Why is intestinal malrotation a problem?

Intestinal malrotation most often isn’t a problem by itself. But it makes the intestine more likely to twist on itself, cutting off blood flow. This is called a volvulus. A volvulus can be very dangerous. This is why intestinal malrotation needs to be treated, even if your child has no symptoms.

What are the symptoms of intestinal malrotation?

In many cases, the condition causes no symptoms. If symptoms do occur, they often happen during a child’s first year and mean the intestine is blocked. These symptoms can include:

• Vomiting that may contain green bile.

• Mildly bloated belly.

• In severe cases, vomiting of blood and blood from the rectum.

• Fever.

• Belly pain and tenderness.

How is intestinal malrotation diagnosed?

Sometimes the problem is found during a test for another health problem. In other cases, the doctor will ask about your child’s symptoms and health history. They will do a physical exam. And your child may have tests. These may include:

• Abdominal ultrasound. Sound waves are used to create an image of the inside of the belly.

• Upper GI (gastrointestinal) series. X-rays are taken of the upper digestive tract from the mouth to the small intestines. Your child swallows a chalky fluid with barium. This liquid coats the inside of the upper digestive tract so it shows up on an X-ray.

• Barium enema. Barium is inserted through the anus into the rectum. It coats the inside of the lower digestive tract so it shows up on an X-ray.

• CT scan. Your child may be given a dye to drink or get dye through an IV. Then several images are taken from different angles.

How is intestinal malrotation treated?

• Intestinal malrotation can be fixed with surgery. During surgery, the intestine is straightened out, and any abnormal bands of tissue are cut. The intestines are then moved to where they will be least likely to twist. If the child still has their appendix, it will be removed.

• If intestine becomes twisted on itself (volvulus), your child will need emergency surgery. The intestines are carefully untwisted. If a part of the intestine has died due to lack of blood flow, this part must be removed. The healthy ends of the intestines are then reattached. If a long length of intestine is removed, a small opening (stoma) may need to be made in the child’s belly. This provides a new way for waste to leave the body. If your child needs a stoma, the doctor will tell you more.

When to contact the doctor

Contact your child’s doctor right away if your child has signs of a volvulus. These include:

• Belly pain and swelling.

• Nausea or vomiting.

• Inability to pass stool.

• Bloody stools.

Call 911 if your child has signs of shock, such as:

• Confusion or unconsciousness.

• Fast heart rate.

• Pale skin.

• Sweating.