Intestinal Malrotation Misdiagnosed


CLEVELAND, OH (Ivanhoe Newswire) — Intestinal malrotation affects one out of every 200 or more babies born in the U.S. It can cause abdominal pain and cramping. In extreme circumstances the condition can be fatal. Some cases are diagnosed right after birth. But one woman had to wait over a decade before she found relief.

Darcy Lamond loves a good game of basketball with her kids, but four years ago a sharp pain in her abdomen nearly sidelined her.

“It felt like someone had driven a stake through my center and it was coming out the back,” said Lamond.

Each of those episodes would last 12 to 18 hours.

Lamond shared, “I wasn’t able to go to work. I certainly wasn’t driving the kids to school. I wasn’t able to take care of the household. I wasn’t able to do anything.”

Lamond found out her pain was caused by intestinal malrotation, a condition she was born with where her intestines did not form correctly inside her abdomen. After she was diagnosed at age 26, she went from doctor to doctor for nearly 15 years to get her symptoms under control. Then she met Kareem Abu-Elmagd, MD, PhD, FACS, Director, Gut Rehabilitation and Transplantation at the Cleveland Clinic.

Dr. Abu-Elmagd said, “The solution is to reconstruct the whole gut the way it is supposed to be. Like you are arranging your kitchen and your bathroom.” (Read Full Interview)

Dr. Abu-Elmagd pioneered the new surgery, where he moved the intestines to secure them inside the abdomen after rotating the bowel 180 degrees. After the procedure, Lamond felt immediate relief.

She said, “Now I feel like more of a complete person.”

A person who is not missing any part of the game.

Since this condition is often misdiagnosed, doctors at the Cleveland Clinic say most patients with malrotation tend to already have their gallbladder and appendix out. The original physicians may have thought the symptoms of malrotation were related to those organs.

Contributors to this news report include: Milvionne Chery, Producer; Cyndy McGrath, Supervising Producer; Hayley Hudson, Assistant Producer; Roque Correa, Editor.

To receive a free weekly e-mail on Medical Breakthroughs from Ivanhoe, sign up at:





REPORT:       MB #4481

 BACKGROUND: An intestinal malrotation is an abnormality that can happen early in pregnancy when a baby’s intestines don’t form into a coil in the abdomen. Malrotation means that the intestines are twisting, which can cause obstruction. Some kids with malrotation never have problems and the condition isn’t diagnosed. But most develop symptoms and are diagnosed by one year of age. Although surgery is needed to repair malrotation, most kids will go on to grow and develop normally after treatment. Malrotation can lead to complications such as a condition called volvulus, where the bowel twists on itself, cutting off the blood flow to the tissue and causing the tissue to die. Symptoms of volvulus, including pain and cramping, are often what lead to the diagnosis of malrotation. Also, bands of tissue called Ladd’s bands may form, obstructing the first part of the small intestine.


TREATMENT: Malrotation is considered an emergency situation and the development of volvulus is considered a life-threatening condition. Surgery is required to fix the problem. Often, the baby will be started on intravenous fluids to prevent dehydration. Antibiotics will be given to prevent infection. A volvulus is surgically repaired as soon as possible. First, the intestine is untwisted and checked for damage. If the intestine is healthy, it is then replaced in the abdomen. If the blood supply to the intestine is in question, the intestine may be untwisted and placed back into the abdomen. 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.


NEW TECHNOLOGY: Kareem Abu-Elmagd, MD, PhD, FACS, Director of Gut Rehabilitation and Transplantation at Cleveland Clinic talked about treatment: “Then I start doing the procedure by putting everything in its anatomical position which is like doing a transplant. It’s a combination of how to dissect the organs from the way they are now and then put them back together.” He also has advice for other physicians: “The take home message is for a physician to listen to the patients. It’s hurting me that the patients know more than a lot of physicians particularly when it comes to innovative procedures. The Ladd procedure to me it’s obsolete; it does not solve the problem. Hopefully the innovative technique we developed will be published and be available to everyone. I would always be available to any physician in the world, any patient or parents of kids to give them the advice and help somebody to take care of them.”

(Source: Kareem Abu-Elmagd, MD, PhD, FACS)


Caroline Auger

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at

Doctor Q and A

Read the entire Doctor Q&A for Kareem Abu-Elmagd, MD, PhD, FACS

Read the entire Q&A