Intestinal obstruction due to congenital malrotation of midgut in the newborn infant and children is a rare disease and was rarely discussed in Korean literature.
Malrotation described by previous authors as results from incomplete rotation or arrest of the normal rotation of mid-gut that portion of the intestine supplied by the superior mesenteric artery. Malrotation may produce duodenal or distal small bowel obstruction in the neonate or in the older child. High obstruction due to compression of the duodenum by peritoneal bands, Ladd´s bands, and distal obstruction due to compression by midgut volvulus.
A case of typical malrotation of infant, nine days after birth, have experienced, diagnosed and treated in department of general surgery, Chung Nam National University Hospital is present in this paper. This case, we have experienced, compriced arrest of cecum in the right upper quadrant under right lobe of liver, duodenal obstruction due to compression by two fibrotic bands and volvulus of small bowel associated with malattachment and abnomality of the small bowel mesentery to the post
erior peritoneal wall, and required prompt operation because of the risk of intestinal obstruction. After exploration, careful division of both hepatocolic and duodenojejunal bands, reduction of the volvulus, small bowel was rotated in a counterclockwise direction twice until the volvulus has been reduced, a normal oblique mesenteric attachment extending from the Treitz ligament to the right iliac fossa have taken place in order.
Postoperative course was relatively smooth and uneventful except a temporaly trouble, vomiting and abdominal distension which was relieved by decompression with Levin tube in the postoperative 3rd day and discharged after 14ths hospitalization without any other trouble.
References were also reviewed.
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