장 이상회전증의 임상적 고찰 = A Clinical Study of Intestinal Malrotation

다국어 초록 (Multilingual Abstract)

Purpose) Bilious vomiting in the neonatal period may be a serious surgical problem. Intestinal malrotation has a variable clinical presentation and is one of the most important diseases to be diagnosed differently in such situations. This study was performed to analyze the clinical characteristics of patients with intestinal malrotation.
Subject and Methods) A retrospective review of 11 patients who had intestinal malrotation and received operation at the Pusan National University Hospital from Jan 2001 to Dec 2005 was done.
Results) Among 11 cases of intestinal malrotation, there were 8 males and 3 females with male predominance. At the time of operation, 10 patients(90.9%) were in the neonatal period. According to clinical manifestations, the most common symptom was bilious vomiting that was seen in 11 cases(100%). Ultrasonographic examination was performed in all symptomatic cases and a abnormal location of SMA/SMV or 'whirl-pool' sign was seen in them. According to operative findings, malrotation only was 6 cases(54.5%) and malrotation with midgut volvulus was 5 cases(45.5%). After a definite procedure, adhesive intestinal obstruction was developed in 3 cases and among them one case required re-operation. There was no mortality case.
Conclusions) Intestinal malrotation could be concerned preferentially for patients presenting bilious vomiting at the neonatal and infantile period. And proper diagnostic attempts and early surgical management will show a good result.