Intestinal malrotation
Disease Information
Overview
A great thing about CAIR is that all of the clinicians who take care of the patients are in the same space. Not only does this make it easier for us to communicate, it also makes it more convenient for families.
--Christopher Duggan, MD, MPH, medical director, Center for Advanced Intestinal Rehabilitation (CAIR), Boston Children's Hospital
When a fetus is about five weeks old, her intestine exits her abdomen into the amniotic fluid (where there’s more space), and continues to grow there. At around ten weeks, the intestine re-enters the abdomen, and makes two turns. Sometimes the intestines don’t make the turns as they should, resulting in the congenital (present at birth) condition known as intestinal malrotation.
Intestinal malrotation itself isn’t much of a concern, but it puts your child at higher risk for two serious complications:
- volvulus – when the intestine twists in on itself, potentially cutting off the blood supply
- intestinal obstruction – when a stalk of fibrous tissue known as Ladd’s bands creates a blockage that prevents the intestine from functioning
Intestinal malrotation with volvolus
click to enlarge
It’s fairly common that a baby is born with intestinal malrotation; it affects about one in every 500 babies in the United States. Some babies may not have symptoms until they become children, teens or adults. Others may go through their entire life with no symptoms, never have a problem and never be diagnosed.
Of babies who are diagnosed with intestinal malrotation:
- 25 to 40 percent are diagnosed in the first week of life
- 50 to 60 percent are diagnosed within the first month of life
- 75 to 90 percent are diagnosed by age 1
Although malrotation occurs equally among boys and girls, boys are more likely to become symptomatic by the first month of life.
How Children’s Hospital Boston approaches intestinal malrotation
At Children’s, we treat children with intestinal malrotation in our Center for Advanced Intestinal Rehabilitation (CAIR), one of the largest centers of its kind in the United States. Each year, our program cares for about 200 children from the United States and abroad.
Our program is staffed by a team of experts with lots of experience in caring for children with intestinal problems and their families. Our specialists include:
- physicians trained in surgery, gastroenterology and nutrition
- registered dieticians
- nurse practitioners
- nurses
- pharmacist
- social worker
- residents, fellows and students
Call 617-355-5275 for an appointment.
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| Watch surgeons perform a serial transverse enteroplasty (STEP) bowel lengthening and tapering procedure on a patient with short bowel syndrome (SBS) during a live webcast. |
Intestinal malrotation: Reviewed by Christopher P. Duggan, MD, MPH
© Children’s Hospital Boston, 2011
