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The risk of midgut volvulus in patients with abdominal wall defects: A multi-institutional study. J Pediatr Surg 2017 Jan;52(1):26-29

Date

11/17/2016

Pubmed ID

27847120

DOI

10.1016/j.jpedsurg.2016.10.014

Scopus ID

2-s2.0-85006762145 (requires institutional sign-in at Scopus site)   23 Citations

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.

Author List

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

Authors

Laura Cassidy PhD Associate Dean, Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Amy Wagner MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Birth Weight
Digestive System Abnormalities
Female
Gastroschisis
Gestational Age
Hernia, Umbilical
Humans
Infant, Newborn
Intestinal Volvulus
Male
Retrospective Studies
Risk Factors