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KMID : 0381219740060060310
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Journal of RIMSK
1974 Volume.6 No. 6 p.310 ~ p.318
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Malrotation of the Intestine
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Abstract
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The alimentary canal is at first a simple tube suspended in the midline of the abdominal cavity. Between the sixth and tenth weeks of intrauterine life, the alimentary tube grows so rapidly that it cannot be accommodated in the coelomic cavity. Most of the midgut is extruded into the base of the umbilical cord forming a temporary physiologic hernia. In this hernial sac, primary rotation of midgut took place 90 degree counterclockwise direction. The duodenojejunal loop rotated further 9o degree counterclockwise, thus total 180 degree rotation of duodenojejunal loop took place in this sac. The, peritoneal cavity grows and about the tenth week the midgut is withrrawn into the abdomen, where it rotates in a counter-clockwise direction up to the 270 degree from the start. This is the second stage of intestinal rotation. Cecum passes from the right upper quadrant until it finally ends in the right lower quadrant. The ascending and descending mesocolons fuse to the posterior wall of the abdomen, anchoring the mesentery from the ligament of Treits to the ileocecal angle. The is the final stage of the rotation and it occurs during the ends of 11th week and 5 month of intrauterine life.
Abnormal rotation prccess lead to lack of attachment of the mesentery to the posterior abdominal wall, to reversed or incomplete rotation of the cecum or to a completely rotated but mobile and unattached cecum. There are two important consequences: 1) obstruction of the duodenum; 2) midgut volvulus.
In this paper, embryologic development, symptomatology and method of treatment were discussed with the-references to the literatures.
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