Assessment of recurrent abdominal symptoms after Ladd procedure: clinical and radiographic correlation.

Abstract:

BACKGROUND/PURPOSE:Obstructive symptoms in a patient post-Ladd procedure raise the question of recurrent volvulus. Our objective is to determine the incidence and the radiographical evaluation of recurrent volvulus and abdominal complications after a Ladd procedure. METHODS:One hundred ninety-five patients who underwent a Ladd procedure for malrotation for 10 years were retrieved from a database. Forty-eight patients were excluded (false-positive studies, heterotaxy, diaphragmatic hernia, abdominal wall defects). Of the remaining 147, 38 patients presented with abdominal symptoms. Surgical records and imaging were reviewed. RESULTS:Of 38 patients, 33 had imaging studies including abdominal radiographs (AXR) and/or upper gastrointestinal examinations. Of these 33 patients, 17 had normal or expected imaging findings on AXR and/or upper gastrointestinal. Of the 11 patients who had surgery, 8 had an AXR. Of these, only a single patient had a normal AXR. The most common post-Ladd complication found at reoperation was small bowel obstruction secondary to adhesions (5.4%). One patient (0.7%) had midgut volvulus. CONCLUSION:Although recurrent volvulus is a feared postoperative Ladd complication, it rarely occurs. Adhesive small bowel obstruction is more common, and an AXR with clinical findings is sufficient for diagnosis.

journal_name

J Pediatr Surg

authors

Biko DM,Anupindi SA,Hanhan SB,Blinman T,Markowitz RI

doi

10.1016/j.jpedsurg.2011.03.018

subject

Has Abstract

pub_date

2011-09-01 00:00:00

pages

1720-5

issue

9

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(11)00233-8

journal_volume

46

pub_type

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