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

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_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Fawley JA,Abdelhafeez AH,Schultz JA,Ertl A,Cassidy LD,Peter SS,Wagner AJ

doi

10.1016/j.jpedsurg.2016.10.014

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

26-29

issue

1

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(16)30475-4

journal_volume

52

pub_type

杂志文章,多中心研究

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