Faculty Collaboration Database

Is isomerism a risk factor for intestinal volvulus? J Pediatr Surg 2018 Jun;53(6):1118-1122

Date

04/02/2018

Pubmed ID

29605269

DOI

10.1016/j.jpedsurg.2018.02.071

Scopus ID

2-s2.0-85044513214 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

INTRODUCTION: Isomerism, or heterotaxy syndrome, affects many organ systems anatomically and functionally. Intestinal malrotation is common in patients with isomerism. Despite a low reported risk of volvulus, some physicians perform routine screening and prophylactic Ladd procedures on asymptomatic patients with isomerism who are found to have intestinal malrotation. The primary aim of this study was to determine if isomerism is an independent risk factor for volvulus.

METHODS: Kid's Inpatient Database data from 1997 to 2012 was utilized for this study. Characteristics of admissions with and without isomerism were compared with a particular focus on intestinal malrotation, volvulus, and Ladd procedure. A logistic regression was conducted to determine independent risk factors for volvulus with respect to isomerism.

RESULTS: 15,962,403 inpatient admissions were included in the analysis, of which 7970 (0.05%) patients had isomerism, and 6 patients (0.1%) developed volvulus. Isomerism was associated with a 52-fold increase in the odds of intestinal malrotation by univariate analysis. Of 251 with isomerism and intestinal malrotation, only 2.4% experienced volvulus. Logistic regression demonstrated that isomerism was not an independent risk factor for volvulus.

CONCLUSION: Isomerism is associated with an increased risk of intestinal malrotation but is not an independent risk factor for volvulus.

TYPE OF STUDY: Prognosis study.

LEVEL OF EVIDENCE: Level III.

Author List

Landisch RM, Loomba RS, Salazar JH, Buelow MW, Frommelt M, Anderson RH, Wagner AJ

Authors

Matthew W. Buelow MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Jose Salazar Osuna MD Assistant Professor in the Surgery 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

Adolescent
Child
Child, Preschool
Cross-Sectional Studies
Female
Heterotaxy Syndrome
Humans
Infant
Infant, Newborn
Intestinal Volvulus
Logistic Models
Male
Prognosis
Risk Factors