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Malrotation
and volvulus
Information for families
Great Ormond Street Hospital
for Children NHS Trust
This leaflet explains about malrotation and volvulus,
how they can be treated, and what to expect
when your child comes to Great Ormond Street Hospital.
What is malrotation?
Malrotation is an abnormality of the bowel, which happens Gallbladder
while the baby is developing in the womb.
Pancreas
from the stomach to the rectum. The bowel then moves into the Small intestine
umbilical cord temporarily while it develops into the large and small bowel. Large intestine
Around the tenth week of pregnancy, the bowel moves back into the abdomen and coils up to fit into the limited space there. If the bowel does not coil up in the correct position, this is called malrotation. Malrotation can be associated with other problems, but the doctors will examine your child Terminal ileum
What is volvulus?
This is a complication of malrotation and occurs when the bowel twists so the blood supply to that part of the bowel is cut off.
What are the symptoms of
What causes malrotation
malrotation and volvulus?
and volvulus and how
common are they?
Malrotation may not have any symptoms. Many people are (adhesions), which block the first part of the small bowel How is malrotation and
volvulus diagnosed?
or liquid can pass the twisted portion, your child may also pass as your child is unable to digest food as usual. If the condition is not treated,
your child will become
dehydrated which can be life-
threatening. the symptoms of
dehydrationmay appear in phases,
and include lethargy, wet nappies
less frequently than normal and
the soft spot (fontanel) on the
top of the head may be sunken.
How are they treated
and are there any
she will need a ‘drip’ of fluids for alternatives?
What does
the operation involve?
dehydration due to the lack of fluids being absorbed, can and separate any adhesions. If the bowel looks healthy, the What happens before the
operation?
cause problems in diagnosing appendicitis later in life. Your child’s surgeon will explain the operation in detail, discuss likely to need a stoma, the stoma care nurse specialist will visit you to explain further. Are there any risks?
Your child will be able to go home once he or she is feeding When you go home
of bleeding during or after the operation. Every anaesthetic for at least three days, and we will give you the medications to What happens
afterwards?
What is the outlook
Support group
for children with
malrotation and volvulus?
Gut Motility Disorders Support
Network
your child had a large amount of bowel removed, he or she may need to stay on TPN for a longer period, sometimes for a year or longer, until the bowel can absorb enough nutrients for normal growth and development. Adhesions can form after any abdominal surgery, and can cause discomfort. To be filled in by your doctor, nurse or pharmacist before you go home YOUR CHILD’S MEDICATIONS
It can be confusing if you’re child is taking several different medications. Use this as a reminder of what medications you gave at what time. YOUR CHILD’S MEDICATIONS
You should call your family doctor or the ward if:
• your child is in a lot of pain and pain relief does not
seem to help
• your child is not keeping any fluids down or has signs of
dehydration
• your child has a high temperature of 37.5°C or higher, a
paracetamol does not bring it down
• the operation site is red or inflamed, and feels hotter
than the surrounding skin
• there is any oozing from the operation site.
If you have any questions, please call Rabbit Ward
on 020 7829 8818 or Hedgehog Ward on 020 7829 8819.
Great Ormond Street Hospital for Children NHS Trust Great Ormond Street London WC1N 3JH Tel: 020 7405 9200 www.goshfamilies.nhs.uk www.childrenfirst.nhs.uk

Source: http://www.ewert.dk/malrotation.pdf