ORLANDO, Fla. (Ivanhoe Newswire) — It happens in the womb: usually around the tenth week of pregnancy. The baby’s intestines do not form correctly in the abdomen and then fail to coil in the proper position. If the condition is not recognized early, the damage can be devastating. Details on how parents can spot the signs early on.
Kareem Abu-Elmagd, MD , Cleveland Clinic says, “It’s about one of two hundred to five hundred kids are born with the malrotation.”
Some children don’t have any symptoms until they become adults. But for the kids who do have symptoms, it’s critical to get them help right away.
Dr. Abu-Elmagd continued, “The intestine is an unforgivable organ and if you cut out the blood supply it’s very, very, very rare to untwist it before it’s already dead.”
Then a transplant is needed or in some cases the children can die. However, there are signs parents can look for before the condition worsens.
“They develop nausea, vomiting, or severe abdominal pain,” explained Dr. Abu-Elmagd.
Some other symptoms: constipation alternating with diarrhea, little or no urine, blood in the stool, and your child may cry while pulling their legs up and then suddenly stop crying. Spotting these signs quickly can not only save your baby’s intestine, but also their life.
About 60 percent of these cases are diagnosed within the first week of life. The condition also occurs equally in girls and boys. However, boys are more likely than girls to show symptoms in the first month of life.
Contributors to this news report include: Milvionne Chery, Field Producer; Roque Correa, Editor.
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SAVE YOUR BABY FROM INTESTINAL MALROTATION
BACKGROUND: Intestinal malrotation occurs in 1 in 500 live births. It is a condition that is congenital and results from a problem in the normal formation of the fetal intestines. There is a disruption in the usual steps that the intestines follow to arrive at the correct position within the abdomen. Malrotation causes the parts of the intestine to settle in the wrong part of the abdomen which can cause them to become blocked or to twist. Intestinal volvulus is a condition in which the bowel becomes twisted which may be the result of malrotation. Twisted intestines may become blocked or may become injured when the twisting cuts off the intestine’s blood supply. If the blood supply is cut off for a prolonged period, some of the entire intestine may die which can be fatal. Volvulus is therefore an emergency that requires immediate surgical treatment. Malrotation of the bowel during fetal development may predispose infants to volvulus, although volvulus can occur in the absence of malrotation. Volvulus associated with malrotation often occurs early in life, frequently in the first year.
SYMPTOMS AND DIAGNOSIS: One of the earliest signs of malrotation is abdominal pain and cramping caused by the inability of the bowel to push food past the obstruction. A baby with cramps and pain due to malrotation frequently follows a typical pattern where he or she will begin crying while pulling his or her legs up, stop crying suddenly, act normal for 10 or 15 minutes, then begin crying suddenly again, starting the pattern all over. Other common symptoms of malrotation may include frequent vomiting, poor appetite, blood in the stool, fever, and being lethargic. After performing a thorough physical exam, the doctor will order tests that evaluate the position of the intestine, and show whether it is twisted or blocked. These tests may include an abdominal x-ray that may show any intestinal obstructions; a barium enema x-ray, which is a liquid that makes the intestine show up better on the x-ray; or a CT scan, which uses computers and x-rays to produce many pictures from multiple angles to give doctors an accurate picture of the body. In the case of possible malrotation, the doctor will use a CT scan to look for a blockage in one of the intestines.
MANAGEMENT AND TREATMENT: Surgery is required to fix the problem. First, the intestine is untwisted and checked for damage. If the intestine is healthy, it is then placed back in the abdomen. If not, another operation is performed within 24 to 48 hours to check the health of the intestine. If it appears that the intestine has been damaged, the injured section may be removed. For cases in which there is a large section of intestine that is damaged, a significant amount of intestine may be removed. When this occurs, the remaining parts of the intestine may not be able to be attached to each other surgically. To correct this, a colostomy may be done to enable the digestive process to continue. With a colostomy, the two remaining healthy ends of intestine are brought through openings in the abdomen. Stool will pass through the opening (called a stoma) and then into a collection bag. The colostomy may be temporary or permanent, depending on the amount of intestine that needed to be removed. Although surgery is required to repair malrotation, most children experience normal growth and development once the condition is treated and corrected.
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