Paediatrics Q10

Malrotation and Volvulus in Neonates

Presentation

1. Symptoms:

2. Green, bilious vomiting

3. Blood in stool, usually painful when passing.

4. Sudden onset of symptoms

 

Age Group: Primarily affects neonates.

Diagnosis

i. Abdominal X-ray: Look for a “coffee bean” shape, also known as the “Omega sign.”

ii. Barium Enema: This can help confirm the diagnosis and might show twisting of the bowel.

Treatment

. ABCDE Protocol: Initial resuscitation should follow the ABCDE protocol (Airway, Breathing, Circulation, Disability, Exposure).

. Nasogastric Tube Decompression: Insert a nasogastric tube to decompress the stomach and alleviate some of the symptoms.

. Surgical Referral: Immediate referral to paediatric surgery for laparotomy and potential bowel resection is required to correct the underlying issue.

 

Early diagnosis and immediate surgical intervention are critical to prevent complications such as bowel necrosis.

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